How can I create an appointment form with payment

  • Profile Image
    Asked on July 29, 2017 at 03:25 AM

    Hi Jotform,


    I had created a basic online appointment form for my clinic:

    However, what I would like to add is appointment slot based on certain time slots,

    example: 9am-11am, 11am-1pm, 1pm-3pm

    And on top of each time slot, the patient can get to choose their preferred physicians.

    After selecting their appointment slots and the physicians, they would confirm it by paying to us via our Paypal account. 


    1) Patient would like to purchase a treatment slot on the 10th August at the 11am-1pm time slot for 3 person and treatment to be done by Physician B. A treatment session is 300$ 

    2) Patient would like to purchase a treatment slot for 1 person on the 12th August at the 1pm-3pm time slot and also another time slot on the 20th August at 9am-11am. Both treatment sessions to be done by Physician A.


  • Profile Image
    Answered on July 29, 2017 at 06:56 AM

    To my understanding, you would like to ask your patients the time and date of their preferred appointment and they will be charged based on their selected treatment session, is that correct?

    I understand that there is a fix time schedule per day, however, would there also be fix dates that your patients can only select? And, once a schedule is selected, it should not be available for other patients to select in the future, correct?

    I believe this can also be achieved without the use of the Appointment Slot widget but with a date field and a drop-down field that lists the available time.

    To ensure that the selected date and time will not be selected again, you can pass the value of that date field and time field into a separate textbox field — How-to-Insert-Text-or-Mathematical-Calculation-into-a-field-using-a-Condition

    Then, you can have that textbox field as a unique question field that will warn patients if they attempt to submit an appointment that is similar to previously submitted one.



    With regards to setting up an amount based on the treatment drop-down field, you can set a calculation value to that drop-down field — How-to-Assign-Calculation-Value

    Then, you can pass the selected value into a Form Calculation widget then into the PayPal payment field — How-to-pass-a-calculation-to-a-payment-field

    As for accepting multiple appointments in a submission, I'm afraid it would not be possible. Your patients need to make a submission per appointment.

    If, in any case, I have misunderstood your concern or you have other questions, please feel free to contact us again anytime.