Available on

Apple Android Windows

Hospital Clown Request Form Mobile App

Use the Hospital Clown Request Form mobile app to allow hospitals to request clown services such as Balloon Sculpting, Hospital Visit, Face painting and Parades for children hospitals and pediatric departments. GoCanvas allows you to have your submitted data emailed to you on a periodic basis of your choice.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

Want to learn more about GoCanvas?

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Take a peek inside the Hospital Clown Request Form Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

  • {{data.title}}

Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico multiline

    Send to:

  • Ico statictext

    The services of the <Insert Company Name> are requested for the following activities:

  • Ico checkbox

    Balloon Sculpting

  • Ico checkbox

    Hospital Visit

  • Ico checkbox

    Face painting

  • Ico checkbox


  • Ico multiline


  • Ico multiline

    Comments/ Event Description:

  • Ico textbox

    Contact Name:

  • Ico textbox


  • Ico multiline


  • Ico textbox


  • Ico time

    Event Start Time

  • Ico time

    Event Stop Time

  • Ico date

    Event Date

  • Ico multiline

    Event Address:

  • Ico integer

    # of Clowns Requested

  • ...and More!

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