Kyruus Blog

Engaging Patients Through Appointment Request Forms: How Much is Too Much?


An analysis of leading health systems’ appointment request forms.

Many health systems allow patients to submit electronic physician appointment requests from their online web and mobile applications. Online appointment request forms can be an effective way to generate leads and attract patients to your organization’s services.

However, form abandonment is a significant risk that could prevent patients with legitimate clinical needs from getting the services they need from your organization. 

 Factors that are frequently cited as drivers of form abandonment include:

  • Length of form– will the user be intimidated by a long list of wordy questions?
  • Sensitivity of information being requested– is the information too personal?
  • Credibility of website– does the website look secure?
  • Surprises or irrelevant information– will the user be surprised or turned off by requests for information that seem irrelevant to the core purpose of the form? 

To see how the industry stacks up to best practices, we performed an analysis of 20 appointment request forms for leading hospital systems across the country[1]. The results showed a wide variance in length, nature of content, and clarity of purpose. We classified the questions across all forms into the following categories:

Legend:     [S] = Potentially sensitive information    [E] = Potentially esoteric information that the patient may not know




·      Name
·      Gender
·      Marital status [S]
·      Race / ethnicity [S]
·      Patient language

Contact information

·      Email
·      Phone
·      Address [S]
·      Name of requestor, if not patient
·      SSN [S]

Personal identifiers

·      MRN [E]
·      Patient DOB

Lead source

·      Referring physician name
·      Do you have a referral? [E]
·      PCP name
·      How did you hear about us?

Health information

·      New or return patient?
·      Type of care (e.g. PCP vs specialist, adult vs pediatric) [E]
·      Patient hearing impaired? [S]
·      Reason for appointment [S]
·      Department / specialty [E]
·      Related to work?
·      Related to auto accident?
·      Have you had testing in last 6 months? [S]


·      Insurance plan
·      Insurance card #
·      Policy holder name
·      Policy holder DOB [E]
·      Insurance group # [E]


·      Preferred location
·      Preferred time of contact
·      Provider gender preference
·      Preferred day / time
·      Preferred physician


·      Additional information
·      Sign up for newsletter

Calls to action

·      Live chat
·      Direct scheduling

Key Findings

The median number of questions was 16. As per the graphic below, a study by Eloqua showed that the majority of online lead generation forms have between 5-10 questions, and that a significant drop-off in form completion rate occurs after 7 questions.


The majority of forms we reviewed contained between 8 and 17 questions. One form had 60 questions stretched across 3 pages of content; it’s probably safe to say that 60 questions are likely to overwhelm the user to the point of abandoning the form!


A minimal viable set of 5 common questions. Our analysis of the frequency of questions across the 20 forms showed that there is clearly a set of five common questions, which likely represent the "minimal viable set" of information required to successfully act on a patient request. Those are highlighted in the green box in the chart below.


We also observed a long tail of additional questions that might be useful for tailoring a form depending on the nature of services offered at a given hospital system, the target patient population, and the intended call to action. For instance, some forms asked whether the patient was a new or return patient; a health system may choose to offer different programs or workflows depending on how the user classifies herself.

A good number of questions asked for esoteric information that the patient may not be likely to know, such as their medical record number (MRN), insurance group number, or which department or specialty they need to see. Remember that the patient may not know whether their itchy eye warrants seeing a dermatologist, ophthalmologist, or a primary care physician. Every question like this that may create anxiety on the part of the patient has a chance of leading to abandonment.

Finally, some forms asked for information that is likely to be perceived as sensitive or overly personal, such as social security number and marital status. It’s not hard to imagine that information of that nature could deter patients from being willing to complete the form, particularly since that information seems irrelevant to the appointment request process.

Most forms communicated clear expectations on response time; 3 offered real-time options in the form of live chat and direct online scheduling. At the end of the day, the submission of an appointment request form represents a commitment on the part of the recipient to respond to the submitter in a timely manner. To that end, all but 3 forms communicated an expected turn-around time for response that ranged from immediate to 2 business days.

However, in our personal experiences, we have had appointment requests go unfulfilled because the recipient organization failed to respond within the stated time period. Those experiences led us to turn away from those organizations and seek services elsewhere. If you do publish an expected response time (which we certainly recommend), make sure you have the resources and workflows in place to ensure fulfillment of your response time commitments.


One of the forms offered a live chat feature, through which the user could make their request through real-time communication with a remote agent.

Two of the forms that were assessed offered online scheduling, though only for a small a subset of physicians (less than 5% of the total physician network in both cases). In those cases, the user was able to choose a physician by name, select a specific appointment slot by day and time, and actually book the appointment online. Our research has shown that timeliness of appointment availability is a top 3 factor in a patient’s selection of a physician, and 38% of patients prefer to book appointments online[2], so the ability to surface appointment inventory and online booking capabilities via a self-service website potentially addresses a key unmet need in the market.


Key tips for optimizing lead generation through appointment request forms:

  • Keep your appointment request forms to 7 or 8 key questions or less.
  • Be sure to include the “minimal viable set” of questions to allow your organization to effectively respond (Name, Email, Phone Number, Reason for Appointment).
  • Avoid asking overly sensitive or esoteric questions.
  • Set expectations on response time, and make sure your team is well-staffed and trained to respond to all requests in within the committed window of time.
  • Consider online booking and live chat to engage your potential patients in real-time and provide instant gratification.


[1] The analysis included 8 community-based health systems, 8 urban academic medical centers, and 2 specialty hospitals.
[2] “The Consumer’s Path to Finding a Healthcare Provider.” Kyruus, October 2015.

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Topics: Patient Access