Drag & Drop Form Designer
Dynamic Form Builder
Design customized intake questionnaires, ADHD pre-assessments, clinician mentorship applications, and feedback forms. Drag input components directly onto the canvas.
Input Types Palette
Click or DragDrag an input type into the form canvas, or click any component to add it immediately.
Single-line Text
Short response, name, or single line answer
Multi-line Paragraph
Long clinical notes, personal reflections, or details
Dropdown Select
Pick one choice from a dropdown menu
Checkboxes (Multi-choice)
Select multiple symptoms, modalities, or goals
Radio Buttons (Single choice)
Select one exclusive option
Email Address
Validated email address with format verification
Phone Number
Contact phone number
Number Scale / Rating
Numeric rating (e.g. 1-10 intensity rating)
Date Picker
Date of birth, consultation date, or milestone
Form Configuration
New Clinical Survey / Form
Reorder questions using the handles. Configure titles, required flags, and choices.
0 fields configured
Interactive User Preview
New Clinical Survey / Form
A custom form created by Sky Steele.
Embed & Share Custom Form
Use these codes to integrate this form into client intake pages, forum announcements, or emails.
<?php
require_once __DIR__ . '/components/DynamicFormBuilder.php';
$form = getCustomFormBySlug('new-assessment-form');
if ($form) {
echo DynamicFormBuilder::renderForm($form, 'process_form.php', 'Submit Assessment');
}
?>