Health screening form: sign up people for checks at your event

Screening days go wrong at the door: a long line, a clipboard and no idea how many cuffs to bring. I would rather collect sign-ups first. One link tells you who is coming and what they want checked.

Use this when

You run a wellness day, a workplace health week or a pop-up screening at a community event.

Skip it when

You need clinical records, scans or signed medical consent. This form books checks. It does not hold results, and it does not give medical advice.

What is asked and why

Name and phone let you reach people if you change the time. The age group helps you staff the right stations. The checks list is the heart of the form, because it tells you what to prepare. A time slot spreads people out. The question about their own doctor helps you suggest a follow-up. An access note lets guests ask for a seat or step-free entry. The last box says this is a screening, not a diagnosis.

What a guest's AI would ask

"Which checks would you like?" Then "When would you like to come?" Then "Do you need anything to help you attend?" It shows all answers and sends only after a yes. See agent-fillable forms.

Check your local privacy rules before collecting health data. This is a form, not medical advice. Event hosts can browse forms for events and forms for clinics. A referral form helps when someone needs a follow-up, and a general event registration covers the rest.

Questions

How do I cap the number of people per session?

Set max_responses to the number your team can see, then close the form. For separate time windows, use one form per window and share each link on its own.

Does the form diagnose anything?

No. People tick a box that says it is a screening and not a diagnosis. The form only books the checks. Results stay with your team and the attendee's own doctor.

How do I prepare the stations?

Download the CSV and count the checks_wanted column by option. That tells you how many cuffs, glucose strips or vision charts to set out.

Or paste the JSON

Give this to your AI. It needs the AI Form API MCP server or an API key. It makes the form and sends you the link.

text

Create this form with the AI Form API create_form tool (or POST https://aiformapi.com/v1/forms with my API key). Then reply with the public_url.

{
  "title": "Book your health screening",
  "description": "Choose the checks you would like and a time that suits you. Screenings give you a snapshot. They do not replace a visit to your own doctor.",
  "fields": [
    {
      "id": "attendee_name",
      "label": "Your name",
      "type": "short_text",
      "required": true,
      "max_length": 150
    },
    {
      "id": "attendee_phone",
      "label": "Phone",
      "type": "phone",
      "required": true
    },
    {
      "id": "attendee_email",
      "label": "Email",
      "type": "email"
    },
    {
      "id": "age_group",
      "label": "Your age group",
      "type": "single_choice",
      "required": true,
      "options": [
        "Under 18",
        "18 to 34",
        "35 to 49",
        "50 to 64",
        "65 or older"
      ]
    },
    {
      "id": "checks_wanted",
      "label": "Which checks would you like?",
      "type": "multi_choice",
      "required": true,
      "options": [
        "Blood pressure",
        "Blood sugar",
        "Cholesterol",
        "Height, weight and body mass",
        "Vision",
        "Hearing",
        "Skin check"
      ],
      "min": 1
    },
    {
      "id": "preferred_slot",
      "label": "When would you like to come?",
      "type": "single_choice",
      "options": [
        "Early morning",
        "Late morning",
        "Early afternoon",
        "Late afternoon"
      ]
    },
    {
      "id": "screened_before",
      "label": "Have you had a screening like this before?",
      "type": "single_choice",
      "options": [
        "Yes, in the last year",
        "Yes, a while ago",
        "No, this is my first"
      ]
    },
    {
      "id": "why_attending",
      "label": "What brings you to the screening?",
      "type": "multi_choice",
      "options": [
        "Routine check",
        "Family history",
        "My doctor suggested it",
        "My employer offers it",
        "I am curious"
      ]
    },
    {
      "id": "own_doctor",
      "label": "Name of your own doctor or clinic",
      "type": "short_text",
      "max_length": 200
    },
    {
      "id": "access_needs",
      "label": "Anything that would help you attend?",
      "type": "long_text",
      "help": "For example step-free access or a seat.",
      "max_length": 500
    },
    {
      "id": "screening_understood",
      "label": "I understand this is a screening, not a diagnosis",
      "type": "checkbox",
      "required": true
    }
  ]
}

Or call the API

bash

curl -X POST https://aiformapi.com/v1/forms \
  -H "Authorization: Bearer $AIFORMAPI_KEY" \
  -H "Content-Type: application/json" \
  -d '{"title":"Book your health screening","description":"Choose the checks you would like and a time that suits you. Screenings give you a snapshot. They do not replace a visit to your own doctor.","fields":[{"id":"attendee_name","label":"Your name","type":"short_text","required":true,"max_length":150},{"id":"attendee_phone","label":"Phone","type":"phone","required":true},{"id":"attendee_email","label":"Email","type":"email"},{"id":"age_group","label":"Your age group","type":"single_choice","required":true,"options":["Under 18","18 to 34","35 to 49","50 to 64","65 or older"]},{"id":"checks_wanted","label":"Which checks would you like?","type":"multi_choice","required":true,"options":["Blood pressure","Blood sugar","Cholesterol","Height, weight and body mass","Vision","Hearing","Skin check"],"min":1},{"id":"preferred_slot","label":"When would you like to come?","type":"single_choice","options":["Early morning","Late morning","Early afternoon","Late afternoon"]},{"id":"screened_before","label":"Have you had a screening like this before?","type":"single_choice","options":["Yes, in the last year","Yes, a while ago","No, this is my first"]},{"id":"why_attending","label":"What brings you to the screening?","type":"multi_choice","options":["Routine check","Family history","My doctor suggested it","My employer offers it","I am curious"]},{"id":"own_doctor","label":"Name of your own doctor or clinic","type":"short_text","max_length":200},{"id":"access_needs","label":"Anything that would help you attend?","type":"long_text","help":"For example step-free access or a seat.","max_length":500},{"id":"screening_understood","label":"I understand this is a screening, not a diagnosis","type":"checkbox","required":true}]}'

JSON definition

json

{
  "title": "Book your health screening",
  "description": "Choose the checks you would like and a time that suits you. Screenings give you a snapshot. They do not replace a visit to your own doctor.",
  "fields": [
    {
      "id": "attendee_name",
      "label": "Your name",
      "type": "short_text",
      "required": true,
      "max_length": 150
    },
    {
      "id": "attendee_phone",
      "label": "Phone",
      "type": "phone",
      "required": true
    },
    {
      "id": "attendee_email",
      "label": "Email",
      "type": "email"
    },
    {
      "id": "age_group",
      "label": "Your age group",
      "type": "single_choice",
      "required": true,
      "options": [
        "Under 18",
        "18 to 34",
        "35 to 49",
        "50 to 64",
        "65 or older"
      ]
    },
    {
      "id": "checks_wanted",
      "label": "Which checks would you like?",
      "type": "multi_choice",
      "required": true,
      "options": [
        "Blood pressure",
        "Blood sugar",
        "Cholesterol",
        "Height, weight and body mass",
        "Vision",
        "Hearing",
        "Skin check"
      ],
      "min": 1
    },
    {
      "id": "preferred_slot",
      "label": "When would you like to come?",
      "type": "single_choice",
      "options": [
        "Early morning",
        "Late morning",
        "Early afternoon",
        "Late afternoon"
      ]
    },
    {
      "id": "screened_before",
      "label": "Have you had a screening like this before?",
      "type": "single_choice",
      "options": [
        "Yes, in the last year",
        "Yes, a while ago",
        "No, this is my first"
      ]
    },
    {
      "id": "why_attending",
      "label": "What brings you to the screening?",
      "type": "multi_choice",
      "options": [
        "Routine check",
        "Family history",
        "My doctor suggested it",
        "My employer offers it",
        "I am curious"
      ]
    },
    {
      "id": "own_doctor",
      "label": "Name of your own doctor or clinic",
      "type": "short_text",
      "max_length": 200
    },
    {
      "id": "access_needs",
      "label": "Anything that would help you attend?",
      "type": "long_text",
      "help": "For example step-free access or a seat.",
      "max_length": 500
    },
    {
      "id": "screening_understood",
      "label": "I understand this is a screening, not a diagnosis",
      "type": "checkbox",
      "required": true
    }
  ]
}

A health screening form for your wellness day