Physiotherapy course booking form template
Built from your own website, free to start, no card. The demo opens at full width in its own tab.
A physiotherapy course booking form that prices the first appointment, follow-ups per session and what runs alongside the treatment, itemized on screen.
Shown as Ansell Physiotherapy, a sample business. The flow, the pricing logic and the quote it returns are the template; the name, the services and the prices are the sample's, and yours take their place.
3 customer paths · 11 steps · 9 priced items in 3 categories · itemized quote on the page · appointment booking built in — counted from the template itself.
Who this template is for.
Physiotherapy clinics that quote the first appointment, follow-ups per session and what runs alongside the treatment and want each request priced the moment it is made, with the itemized total on screen before anyone follows up.
Clinics booking single sessions only, or practices that bill an insurer rather than the patient.
What your customer goes through.
The first screen asks what they are booking. Each answer sets the path, and every path ends on a priced quote.
Something hurts
A back, a knee, a shoulder — recent or long-standing. The assessment first, then a course.
I want to train without breaking
A movement screen and a programme rather than treatment. One appointment, often no follow-ups.
I have a diagnosis and doubts
Bring the scan and the letter. We will go through it and tell you honestly what we think.
- 01What is going on?
- 02How Many Sessions
- 03The First Appointment
- 04Follow-Ups
- 05Alongside The Treatment
- 06How The Clinic Works
- 07Your Details
- 08The Course, Priced
- 09Pick A Time For The Assessment
- 10The Assessment Is Booked
Along the way it asks for sessions (0–24), so the lines priced per person, per hour or per mile can be multiplied out before the customer reaches the quote.
What it prices.
Sample prices from the demo, in US dollars. Your own rates, taxes and rules replace them the moment you launch.
The First Appointment
- Movement Screen For Sport$55
- Initial Assessment, 50 Minutes$68
- Second Opinion On A Diagnosis$75
Follow-Ups, Per Session
- Sports Massage, Per Session$46
- Follow-Up Treatment, Per Session$52
- Extended Session, Per Session$78
Alongside The Treatment
- Written Rehab Programme$30
- Report For An Insurer Or Employer$40
- Shockwave Therapy, Per Session$65
The rules it states up front.
Policies the sample puts on the request itself, so nobody finds them out by email later. Yours go in the same place.
How The Clinic Works
- We Bill Most Insurers Directly
- We Will Tell You If We Cannot Help
- You Do Not Need A Referral
How it closes.
Name, email and phone before the quote
The request is tied to a real person before the total is shown, so the follow-up has somewhere to go.
An itemized quote, on the page
Every chosen line, multiplied out, with the total. The customer sees it before they leave.
Pick a day and a time
The customer can pick a time for a visit or a call instead of finishing on the spot.
Final screen: “The Assessment Is Booked”
The sample's closing screen. Its wording, like every other line here, is the sample's; yours replaces it.
Related templates.
Build one like this for your own business.
Point Everybooking at your website and it builds a booking flow like this one from your own pages, products and pricing.