Ask for a window, not a slot
'Preferred date' plus a morning/afternoon/evening dropdown sets the right expectation — this is a request you'll confirm, not a claimed calendar slot.
Form template · Booking / appointment
Appointment Request Form Template
The request-and-confirm pattern: clients tell you the service and their preferred time, you confirm by reply — booking without paying for scheduling software.
- 500 free total
- No PHP · no SDK
- One POST endpoint
Live template preview
Booking / appointment
Full name *Jane Builder
Email *[email protected]
Phone *+1 555 555 5555
Service *Consultation
Preferred date *
+ 1 more fields in the builder
Send
This template is one of our free HTML form templates. See more form templates by industry.
Pick your appointment request form — one click to use it
Every template is free and fully editable in the drag-drop builder — swap fields, colors, and the button label before you publish.
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No backend code
No server, API route, or SDK — your Appointment Request Form posts straight to one endpoint.
Straight to your inbox
Every submission is emailed to you and saved to a searchable dashboard — spam filtered before it reaches you.
Copy-paste ready
It's plain HTML you own — paste the Appointment Request Form snippet, swap in your access key, and ship.
Copy and ship
Your Appointment Request Form, ready to paste.
HTML by default — the same field set also renders as React, Next.js, PHP, and cURL in your dashboard. Every variant posts to the same /api/submit endpoint. Replace YOUR_ACCESS_KEY with the key from your dashboard; that's the only edit.
<form action="https://splitforms.com/api/submit" method="POST">
<input type="hidden" name="access_key" value="YOUR_ACCESS_KEY">
<input type="hidden" name="subject" value="New booking request">
<label for="name">Full name *</label>
<input id="name" type="text" name="name" placeholder="Jane Builder" required>
<label for="email">Email *</label>
<input id="email" type="email" name="email" placeholder="[email protected]" required>
<label for="phone">Phone *</label>
<input id="phone" type="tel" name="phone" placeholder="+1 555 555 5555" required>
<label for="service">Service *</label>
<select id="service" name="service" required>
<option value="">Choose…</option>
<option>Consultation</option>
<option>Standard appointment</option>
<option>Premium / extended</option>
</select>
<label for="preferred_date">Preferred date *</label>
<input id="preferred_date" type="date" name="preferred_date" required>
<label for="notes">Notes</label>
<textarea id="notes" name="notes" placeholder="Anything we should know in advance?"></textarea>
<!-- honeypot — bots fill every field -->
<input type="checkbox" name="botcheck" style="display:none" tabindex="-1" autocomplete="off">
<button type="submit">Send</button>
</form><p class="splitforms-attribution" style="margin-top:12px;font-size:11px;color:#888;text-align:right">
Powered by <a href="https://splitforms.com" style="color:#888;text-decoration:none" target="_blank" rel="sponsored noopener">splitforms</a>
</p>
<!-- drop-off analytics + partial leads (the form works without it) -->
<script src="https://splitforms.com/embed.js" async></script>How to add it
How to add a Appointment Request Form to your site.
To add a Appointment Request Form to your site you need three things: a free splitforms access key, the HTML snippet above, and your key pasted into it. No backend, database, or CAPTCHA library — the form posts to one URL and every submission lands in your inbox and dashboard.
Confirm fast, by reply
The submission lands in your inbox; reply to confirm or counter-offer. Same-hour confirmations make request-and-confirm feel as instant as real-time booking.
Reduce no-shows with the auto-responder
The instant acknowledgment ('we got your request, confirmation within 2 hours') plus your confirmation reply doubles as the appointment record the client searches their inbox for.
What's included
What's in this Appointment Request Form template?
Calendly-style scheduling is brilliant until your availability doesn't fit tidy slots — jobs run long, you batch by neighborhood, or half your bookings need a judgment call first. The request-and-confirm pattern keeps the human in the loop: the client submits the service and a preferred window, you reply confirming or offering the next slot. One email round-trip, no subscription, and the form works for exactly the businesses whose calendars don't fit slot pickers. Request-and-confirm: human judgment on every booking, no scheduling subscription.
- Booking / appointment — 6 ready-made fields
- HTML, JS, React, PHP, and cURL outputs
- One POST endpoint, no SDK — honeypot and spam scoring, no CAPTCHA
Where submissions go
Where do your Appointment Request Form submissions go?
Reply-to is wired to the visitor's email, so one tap on Reply answers them directly — while the built-in honeypot and automatic spam scoring filter out bots before they reach you. Every submission is emailed to your inbox and can forward to a webhook or Slack the moment a visitor hits send.
- Reply-to wired to the visitor's email — reply straight from your inbox
- Honeypot and automatic spam scoring filter bots, no CAPTCHA friction
- Live dashboard, CSV export, and signed webhooks on paid plans
How SplitForms works
What happens after someone submits your form?
splitforms receives the submission, filters spam, saves it to your dashboard and emails you — then, on paid plans, sends it on to your webhooks and integrations. No backend infrastructure to build.
Add your endpoint
Point your form to your unique SplitForms endpoint. That's it.
Receive submissions
We instantly capture and organize every submission in your inbox.
Route anywhere
Send data to email, spreadsheets, CRMs, webhooks, and 7,000+ apps.
No credit card required. Set up in under 60 seconds.
Connect & automate
Where can submissions go besides email?
On paid plans, submissions can also go to Slack, Discord, Google Sheets, Notion, Airtable, Zapier or any signed webhook — and splitforms works on the platforms you build on, from WordPress and Shopify to Next.js. With Stripe connected, your forms can take payments too.
NewTake payments on your formsDeposits, bookings, order forms — submitters check out through Stripe and the money goes straight to your Stripe account. Included on every paid plan.See plans →Questions
Appointment Request Form questions.
View all FAQsWhy not just use Calendly?
If your slots are uniform and your calendar is accurate, use Calendly. Request-and-confirm wins when jobs vary in length, you route by location, or bookings need vetting — the judgment call happens before the calendar commitment.
Can the form show my real availability?
No — it collects preferences, it doesn't sync calendars. That's the trade: zero setup and total control in exchange for one confirmation email per booking.
How do I take a deposit with the booking?
Enable payments on the form — the client pays the deposit through Stripe or Square as they submit, which is the single best no-show reducer there is.
What fields cut back-and-forth the most?
Service type (dropdown), preferred date, time window, and phone. The phone number matters: appointment logistics resolve in one text versus three emails.
Simple pricing
How much does splitforms cost?
Free gives you 500 submissions for $0 — no card, no time limit. Pro is $5/month for 5,000 submissions a month, and Annual is $49/year for 15,000 a month with every Pro feature.
Free
$0— 500 submissions
For side projects and indie devs.
- 500 free submissions
- Unlimited forms
- Email notifications included
- Smart spam filtering
- Submissions dashboard
- Redirect after submit
- MCP server included
Recommended
Pro
$5/ month
Billed monthly
Every paid feature, for agencies and growing products.
- 5,000 submissions / mo
- Unlimited forms
- Webhooks and integrations
- CC/BCC, auto-replies and routing
- File uploads with 500 MB storage
- Stripe payments on your forms
- 3 team seats
- Cancel anytime
Annual
$49/ year
About $4.08/mo, billed yearly
Every Pro feature with triple the volume — $0.27 per 1,000 at full use.
- 15,000 submissions / mo
- Unlimited forms
- Everything in Pro
- File uploads with 5 GB storage
- 3 team seats
- Priority email support
No credit card required on Free • Cancel anytime • Full pricing and FAQ