Improve landing pages with our Prescription Request Form generator

Explore our user-friendly form builder to effortlessly collect data from your website visitors. Leverage Instapage and its cutting-edge conversion-focused features to improve engagement and enhance your digital ad campaigns.

Get started

Note: Some features described here might be planned in our roadmap but not yet released. You can open a live chat from within your account and our Support team can offer more details or help you with workarounds.

Landing page builder

Form builder

Landing page optimization

Landing page personalization

Create forms with drag-and-drop interface

Easily create forms without design or coding skills. Simply drag different fields onto your canvas, arrange them the way you like, and customize them to collect the lead data you need.

Add customization and branding elements

Create a form that fits seamlessly into the design of your landing page. Add unique fields, colors, buttons, and layouts that captivate your audience and reflect your brand's identity.

Get your landing pages live faster

Access forms from a dedicated form library to launch your landing page faster. Skip the hassle of adding form embed codes or dealing with extra form building tools.

Maximize efficiency with reusable forms

Save time by cutting down on repetitive tasks. Create your forms once and reuse them multiple times, or start with ready-made form templates that you can customize to fit your needs.

Keep all your forms in one place

Keep all your forms organized in one online library on a single platform. Access your forms anytime and easily reuse them when needed.

Integrate with any app

Send leads over to your favorite email services, marketing automation tools, CRMs, and more to easily connect with them, nurture relationships, and guide them through the sales funnel faster.

Instapage helps Netradyne get a 38.2% conversion lift by powering its return on ad spend

Boost results through landing page optimization

Instapage helps Netradyne get a 38.2% conversion lift by powering its return on ad spend

Personalize experiences for higher engagement and ROI

Personalize experiences for higher engagement and ROI sidebar

Instapage helps Netradyne get a 38.2% conversion lift by powering its return on ad spend

Maximize campaign efficiency with ad mapping

Maximize campaign efficiency with ad mapping sidebar

Instapage helps Netradyne get a 38.2% conversion lift by powering its return on ad spend

Instapage helps Netradyne get a 38.2% conversion lift by powering its return on ad spend

Improve alignment across your creative team

Improve alignment across your creative team sidebar

Instapage helps Netradyne get a 38.2% conversion lift by powering its return on ad spend

Create forms with drag-and-drop interface

Easily create forms without design or coding skills. Simply drag different fields onto your canvas, arrange them the way you like, and customize them to collect the lead data you need.

Add customization and branding elements

Create a form that fits seamlessly into the design of your landing page. Add unique fields, colors, buttons, and layouts that captivate your audience and reflect your brand's identity.

Get your landing pages live faster

Access forms from a dedicated form library to launch your landing page faster. Skip the hassle of adding form embed codes or dealing with extra form building tools.

Maximize efficiency with reusable forms

Save time by cutting down on repetitive tasks. Create your forms once and reuse them multiple times, or start with ready-made form templates that you can customize to fit your needs.

Keep all your forms in one place

Keep all your forms organized in one online library on a single platform. Access your forms anytime and easily reuse them when needed.

Create forms with drag-and-drop interface

Send leads over to your favorite email services, marketing automation tools, CRMs, and more to easily connect with them, nurture relationships, and guide them through the sales funnel faster.

Getting started with the Prescription Request Form builder

Instapage's Prescription Request Form builder offers marketers an easy way to create effective forms for landing pages, helping businesses to grow conversions and enhance user engagement. This guide will take you through the essential steps to get you started with the Form Builder, ensuring a smooth experience as you design your custom forms.

Steps to create your first form using the Prescription Request Form builder

Get started with Instapage by creating an account with a 14-day free trial.
Provide company details and add teammates to complete your account settings.
Open your Dashboard and click on Assets -> Forms -> Create Form.
Design your form from scratch and rename it according to your requirements.
Navigate to the ADD FIELD menu on the left and drop in fields you need, such as text, email, dropdown list, etc.
Customize your form using the FORM Settings and FORM Style options on the right sidebar.
Once finished, click SAVE to add the form to your landing pages, or decline changes by clicking the CLOSE button.

By following these steps, you'll harness the full potential of Instapage's Prescription Request Form builder. Start creating forms that convert today and watch your business thrive!

Get more conversions with Prescription Request Form builder

Improve your Quality Score with quick load technology for landing pages

Increase conversions with content that aligns with your ads and audiences

Achieve maximum ROI by scaling your marketing initiatives

Get started

“Instapage gives us the ability to tailor our landing page content and layout to tell a unique story for each geographical target. The platform also enables us to create different variations with content that performs well for each unique channel. Every marketing team needs this!”

Tamar Friedland, Sr. Director of Global Paid Marketing

"Instapage has truly maximized our digital advertising performance by enabling us to offer matching, personalized experiences for every ad and audience. Now we can scale our landing page experiences as efficiently and effectively as we scale the ads themselves."

Darren Lepke, Marketing Director

"If we have to wait on a developer, our creative velocity plummets. But Instapage has made it possible for us to exponentially grow our advertising programs and convert more customers"

Alex Kracov, Head of Marketing

Leading the way in building high-performing landing pages

Most Implementable Enterprise - Summer 2025

Fastest Implementation Enterprise - Summer 2025

Frequently Asked Questions

What is the Prescription Request Form builder and how does it work?

The Prescription Request Form builder is a tool designed by Instapage that allows businesses to create customized forms tailored to their specific needs. With a user-friendly interface, you can easily drag and drop elements to design your form without any coding required. This streamlines the process of gathering prescription requests, ensuring you capture all necessary information efficiently and effectively.

What features does the Prescription Request Form builder offer?

The Prescription Request Form builder offers a variety of features including customizable templates, integrations with platforms like CRMs and email marketing tools, and real-time collaboration options. It comes equipped with built-in analytics to track form performance, making it easier to optimize for conversions. Additionally, you can personalize forms to provide a tailored experience for users, which helps increase customer trust and engagement.

How does the Prescription Request Form builder compare to competitors?

Instapage’s Prescription Request Form builder stands out due to its ease of use, comprehensive template library, and seamless integrations with various marketing tools. Unlike many competitors, it prioritizes flexibility, allowing users to customize forms extensively without needing any technical expertise. Furthermore, Instapage offers extensive customer support, ensuring that users can get help whenever they need it.

Are there options for optimizing forms created with the Prescription Request Form builder?

Absolutely! The Prescription Request Form builder includes A/B testing capabilities and detailed heatmaps, allowing you to test different form designs and understand user behavior. This optimization feature empowers you to refine your forms based on real data, significantly increasing conversion rates. The built-in analytics dashboard also helps you measure performance metrics to continuously upgrade your forms.

What type of businesses can benefit from the Prescription Request Form builder?

The Prescription Request Form builder is suitable for a wide range of industries, including healthcare providers, pharmacies, and insurance companies. Any business that needs to collect structured information efficiently can benefit from this tool. It allows marketers in various sectors to streamline their data collection processes while enhancing the user experience.

What pricing options are available for the Prescription Request Form builder?

Instapage offers flexible pricing plans for the Prescription Request Form builder, catering to different business sizes and needs. Plans typically include various features such as unlimited forms, A/B testing, and collaboration tools. You can choose a plan that suits your budget while gaining access to powerful form-building capabilities that drive conversions.