diff --git a/backend/src/services/appointments.ts b/backend/src/services/appointments.ts
index bbad675..59e767d 100644
--- a/backend/src/services/appointments.ts
+++ b/backend/src/services/appointments.ts
@@ -4,6 +4,7 @@ import { db } from "../db/index.js";
 import { appointments } from "../db/schema/appointments.js";
 import type { AppointmentInput } from "../lib/appointment-validation.js";
 import type { Appointment } from "../types/appointment.js";
+import * as patients from "./patients.js";
 
 type AppointmentRow = typeof appointments.$inferSelect;
 
@@ -58,9 +59,16 @@ export async function createAppointment(
   userId: string,
   input: AppointmentInput,
 ): Promise<Appointment> {
+  // Link to a patient — creating one when the booking has no file number (e.g.
+  // an AI-imported appointment), so the person shows up on the Patients page.
+  const fileNumber = await patients.ensurePatient(orgId, userId, {
+    fileNumber: input.fileNumber,
+    name: input.name,
+    initials: input.initials,
+  });
   const [row] = await db
     .insert(appointments)
-    .values(columns(orgId, input, userId))
+    .values(columns(orgId, { ...input, fileNumber }, userId))
     .returning();
   return toAppointment(row!);
 }
diff --git a/backend/src/services/patients.ts b/backend/src/services/patients.ts
index 11d195f..640f6d9 100644
--- a/backend/src/services/patients.ts
+++ b/backend/src/services/patients.ts
@@ -11,7 +11,10 @@ import {
   problems,
 } from "../db/schema/patients.js";
 import { HttpError } from "../lib/http-error.js";
-import type { PatientInput } from "../lib/patient-validation.js";
+import {
+  patientInputSchema,
+  type PatientInput,
+} from "../lib/patient-validation.js";
 import type {
   Allergy,
   Encounter,
@@ -314,6 +317,40 @@ export async function generateFileNumber(orgId: string): Promise<string> {
   return String(Number(r?.max ?? 9999) + 1);
 }
 
+// Resolve the file number to attach a denormalized record (e.g. an appointment)
+// to a patient. With a file number, use it as-is. Without one (AI-imported rows),
+// reuse an existing same-name patient when present — deduping repeat rows and
+// re-imports — otherwise create a minimal patient (auto file number, source "ai")
+// so they appear on the Patients page. Returns the file number to link.
+export async function ensurePatient(
+  orgId: string,
+  userId: string,
+  patient: { fileNumber: string; name: string; initials: string },
+): Promise<string> {
+  if (patient.fileNumber) return patient.fileNumber;
+  const [existing] = await db
+    .select({ fileNumber: patients.fileNumber })
+    .from(patients)
+    .where(
+      and(
+        eq(patients.organizationId, orgId),
+        eq(patients.name, patient.name),
+      ),
+    )
+    .limit(1);
+  if (existing) return existing.fileNumber;
+  const created = await createPatient(
+    orgId,
+    userId,
+    patientInputSchema.parse({
+      name: patient.name,
+      initials: patient.initials,
+      source: "ai",
+    }),
+  );
+  return created.fileNumber;
+}
+
 export async function listPatients(
   orgId: string,
   demographicsOnly = false,
diff --git a/frontend/components/analysis/live-hospital-chart.tsx b/frontend/components/analysis/live-hospital-chart.tsx
index 804d99c..a7b3959 100644
--- a/frontend/components/analysis/live-hospital-chart.tsx
+++ b/frontend/components/analysis/live-hospital-chart.tsx
@@ -86,7 +86,7 @@ export function LiveHospitalChart() {
         <div className="h-56 w-full">
           <LiveLineChart
             data={data}
-            margin={{ left: 44 }}
+            margin={{ left: 44, right: 28 }}
             value={value}
             window={WINDOW_SECONDS}
           >
diff --git a/frontend/components/chat/action-preview-card.tsx b/frontend/components/chat/action-preview-card.tsx
index 18cc114..8a2ae3c 100644
--- a/frontend/components/chat/action-preview-card.tsx
+++ b/frontend/components/chat/action-preview-card.tsx
@@ -14,14 +14,16 @@ import { notify } from "@/lib/toast";
 
 type Status = "pending" | "committing" | "done" | "rejected";
 
-const ICONS = {
+export const ACTION_ICONS = {
   appointment: CalendarPlus,
   task: ClipboardList,
   prescription: Pill,
 } as const;
 
+const ICONS = ACTION_ICONS;
+
 // Summarise the proposed record into a couple of readable lines per kind.
-function summarize(data: ActionPreviewData): string[] {
+export function summarize(data: ActionPreviewData): string[] {
   const r = data.record as Record<string, unknown>;
   if (data.kind === "appointment") {
     return [
@@ -44,7 +46,7 @@ function summarize(data: ActionPreviewData): string[] {
   ].filter(Boolean);
 }
 
-async function commit(data: ActionPreviewData): Promise<void> {
+export async function commitAction(data: ActionPreviewData): Promise<void> {
   // Stamp provenance so the committed record is flagged "Added by AI" and shows
   // up for review/editing on the relevant page.
   if (data.kind === "appointment") {
@@ -75,7 +77,7 @@ export function ActionPreviewCard({ data }: { data: ActionPreviewData }) {
   const approve = async () => {
     setStatus("committing");
     try {
-      await commit(data);
+      await commitAction(data);
       setStatus("done");
       notify.success(
         t("chat.actionCard.addedTitle"),
diff --git a/frontend/components/chat/batch-action-preview-card.tsx b/frontend/components/chat/batch-action-preview-card.tsx
new file mode 100644
index 0000000..ae4e70c
--- /dev/null
+++ b/frontend/components/chat/batch-action-preview-card.tsx
@@ -0,0 +1,210 @@
+"use client";
+
+import { AlertTriangle, Check, Sparkles, X } from "lucide-react";
+import { useMemo, useState } from "react";
+import { useTranslation } from "react-i18next";
+
+import {
+  ACTION_ICONS,
+  commitAction,
+  summarize,
+} from "@/components/chat/action-preview-card";
+import { Badge } from "@/components/ui/badge";
+import { Button } from "@/components/ui/button";
+import { Card } from "@/components/ui/card";
+import {
+  Dialog,
+  DialogDescription,
+  DialogFooter,
+  DialogHeader,
+  DialogPanel,
+  DialogPopup,
+  DialogTitle,
+} from "@/components/ui/dialog";
+import type { ActionPreviewData } from "@/lib/ai-chat";
+import { notify } from "@/lib/toast";
+
+type Status = "pending" | "committing" | "done" | "rejected";
+
+// A single approval surface for many agent-proposed records (e.g. an imported
+// file of appointments) instead of one card per record. The clinician reviews
+// the full list in a dialog, removes any they don't want, and adds them all at
+// once. Each commit goes through the same RBAC-gated create endpoint as the
+// single-record card; appointments without a file number create a patient.
+export function BatchActionPreviewCard({ items }: { items: ActionPreviewData[] }) {
+  const { t } = useTranslation();
+  const [open, setOpen] = useState(false);
+  const [removed, setRemoved] = useState<Set<string>>(new Set());
+  const [status, setStatus] = useState<Status>("pending");
+  const [result, setResult] = useState<{ added: number; failed: number } | null>(
+    null,
+  );
+
+  const kept = useMemo(
+    () => items.filter((it) => !removed.has(it.token)),
+    [items, removed],
+  );
+
+  const Icon = ACTION_ICONS[items[0]?.kind ?? "appointment"];
+
+  const addAll = async () => {
+    setStatus("committing");
+    let added = 0;
+    let failed = 0;
+    // Sequential so server-side patient de-dup (by name) sees prior creates.
+    for (const it of kept) {
+      try {
+        await commitAction(it);
+        added += 1;
+      } catch {
+        failed += 1;
+      }
+    }
+    setResult({ added, failed });
+    setStatus("done");
+    setOpen(false);
+    if (added > 0) {
+      notify.success(
+        t("chat.actionCard.addedTitle"),
+        t("chat.actionCard.batch.done", { added, total: kept.length }),
+      );
+    } else if (failed > 0) {
+      notify.error(
+        t("chat.actionCard.failedTitle"),
+        t("chat.actionCard.failedBody"),
+      );
+    }
+  };
+
+  const discardAll = () => {
+    setStatus("rejected");
+    setOpen(false);
+  };
+
+  return (
+    <Card className="w-full gap-3 p-4">
+      <div className="flex items-center gap-2">
+        <Icon className="size-4 text-muted-foreground" />
+        <span className="font-medium text-sm">
+          {t("chat.actionCard.batch.title", { count: items.length })}
+        </span>
+        <Badge className="ml-auto gap-1" variant="secondary">
+          <Sparkles className="size-3" />
+          AI
+        </Badge>
+      </div>
+
+      {status === "done" && result ? (
+        <p className="flex items-center gap-1.5 text-foreground text-sm">
+          <Check className="size-4" />
+          {t("chat.actionCard.batch.done", {
+            added: result.added,
+            total: items.length,
+          })}
+          {result.failed > 0
+            ? ` · ${t("chat.actionCard.batch.failedCount", { count: result.failed })}`
+            : ""}
+        </p>
+      ) : status === "rejected" ? (
+        <p className="text-muted-foreground text-sm">
+          {t("chat.actionCard.batch.discarded")}
+        </p>
+      ) : (
+        <div className="flex items-center gap-2">
+          <Button onClick={() => setOpen(true)} size="sm">
+            {t("chat.actionCard.batch.review")}
+          </Button>
+          <Button onClick={discardAll} size="sm" variant="outline">
+            <X className="size-4" />
+            {t("chat.actionCard.discard")}
+          </Button>
+        </div>
+      )}
+
+      <Dialog onOpenChange={setOpen} open={open}>
+        <DialogPopup className="sm:max-w-lg">
+          <DialogHeader>
+            <DialogTitle>{t("chat.actionCard.batch.dialogTitle")}</DialogTitle>
+            <DialogDescription>
+              {t("chat.actionCard.batch.dialogDescription")}
+            </DialogDescription>
+          </DialogHeader>
+
+          <DialogPanel className="flex max-h-[60vh] flex-col gap-2 overflow-y-auto">
+            {kept.length === 0 ? (
+              <p className="py-6 text-center text-muted-foreground text-sm">
+                {t("chat.actionCard.batch.discarded")}
+              </p>
+            ) : (
+              kept.map((it) => {
+                const lines = summarize(it);
+                const record = it.record as Record<string, unknown>;
+                const newPatient =
+                  it.kind === "appointment" && !record.fileNumber;
+                return (
+                  <div
+                    className="flex items-start gap-2 rounded-xl border bg-card/30 p-3"
+                    key={it.token}
+                  >
+                    <div className="flex min-w-0 flex-1 flex-col">
+                      {lines.map((line, i) => (
+                        <span
+                          className={
+                            i === 0
+                              ? "truncate font-medium text-foreground text-sm"
+                              : "truncate text-muted-foreground text-xs"
+                          }
+                          key={line + i}
+                        >
+                          {line}
+                        </span>
+                      ))}
+                      {newPatient ? (
+                        <span className="mt-1 inline-flex items-center gap-1 text-[11px] text-muted-foreground">
+                          <Sparkles className="size-3" />
+                          {t("chat.actionCard.batch.newPatient")}
+                        </span>
+                      ) : null}
+                      {it.issues && it.issues.length > 0 ? (
+                        <span className="mt-1 flex items-center gap-1 text-warning-foreground text-xs">
+                          <AlertTriangle className="size-3" />
+                          {it.issues[0]}
+                        </span>
+                      ) : null}
+                    </div>
+                    <Button
+                      aria-label={t("chat.actionCard.batch.remove")}
+                      className="shrink-0"
+                      onClick={() =>
+                        setRemoved((prev) => new Set(prev).add(it.token))
+                      }
+                      size="icon"
+                      variant="ghost"
+                    >
+                      <X className="size-4" />
+                    </Button>
+                  </div>
+                );
+              })
+            )}
+          </DialogPanel>
+
+          <DialogFooter>
+            <Button onClick={discardAll} type="button" variant="outline">
+              {t("chat.actionCard.batch.discardAll")}
+            </Button>
+            <Button
+              disabled={status === "committing" || kept.length === 0}
+              onClick={addAll}
+              type="button"
+            >
+              {status === "committing"
+                ? t("chat.actionCard.batch.adding")
+                : `${t("chat.actionCard.batch.addAll")} (${kept.length})`}
+            </Button>
+          </DialogFooter>
+        </DialogPopup>
+      </Dialog>
+    </Card>
+  );
+}
diff --git a/frontend/components/chat/chat-input.tsx b/frontend/components/chat/chat-input.tsx
index f0d7367..e3b7153 100644
--- a/frontend/components/chat/chat-input.tsx
+++ b/frontend/components/chat/chat-input.tsx
@@ -126,7 +126,7 @@ export function ChatInput({
         event.preventDefault();
         submit();
       }}
-      className="w-full overflow-hidden rounded-[28px] border border-border bg-input shadow-sm"
+      className="w-full shrink-0 overflow-hidden rounded-[28px] border border-border bg-input shadow-sm"
     >
       {/* Textarea + toolbar, filling the rounded card. */}
       <div className="bg-input">
diff --git a/frontend/components/chat/chat-panel.tsx b/frontend/components/chat/chat-panel.tsx
index 8c31d03..2b1631f 100644
--- a/frontend/components/chat/chat-panel.tsx
+++ b/frontend/components/chat/chat-panel.tsx
@@ -43,6 +43,7 @@ import {
   ToolOutput,
 } from "@/components/ai-elements/tool";
 import { ActionPreviewCard } from "@/components/chat/action-preview-card";
+import { BatchActionPreviewCard } from "@/components/chat/batch-action-preview-card";
 import { ChatInput } from "@/components/chat/chat-input";
 import { ImportPreviewCard } from "@/components/chat/import-preview-card";
 import { LabChartCard } from "@/components/chat/lab-chart-card";
@@ -65,7 +66,7 @@ import {
   type Effort,
   getModel,
 } from "@/lib/ai-models";
-import type { TemetroUIMessage } from "@/lib/ai-chat";
+import type { ActionPreviewData, TemetroUIMessage } from "@/lib/ai-chat";
 import { getAiConfig } from "@/lib/ai-settings";
 import { API_BASE_URL } from "@/lib/api-client";
 import { getPatient } from "@/lib/patients";
@@ -325,6 +326,14 @@ export function ChatPanel() {
   const renderMessage = (message: TemetroUIMessage, isLast: boolean) => {
     const steps = message.parts.filter((p) => p.type === "data-step");
     const isWorking = status === "submitted" || status === "streaming";
+    // When the agent proposes many records at once (e.g. an imported file),
+    // collapse them into one batched approval instead of a card per record.
+    const actionPreviews = message.parts.filter(
+      (p) => p.type === "data-actionPreview",
+    );
+    const firstActionPreviewIdx = message.parts.findIndex(
+      (p) => p.type === "data-actionPreview",
+    );
     return (
       <Message from={message.role} key={message.id}>
         <MessageContent className="w-full">
@@ -405,6 +414,18 @@ export function ChatPanel() {
               return <ImportPreviewCard data={part.data} key={key} />;
             }
             if (part.type === "data-actionPreview") {
+              if (actionPreviews.length >= 2) {
+                // Render the batch once (at the first proposal), skip the rest.
+                if (i !== firstActionPreviewIdx) return null;
+                return (
+                  <BatchActionPreviewCard
+                    items={actionPreviews.map(
+                      (p) => (p as { data: ActionPreviewData }).data,
+                    )}
+                    key={key}
+                  />
+                );
+              }
               return <ActionPreviewCard data={part.data} key={key} />;
             }
             if (part.type === "data-appointmentList") {
@@ -452,8 +473,8 @@ export function ChatPanel() {
 
   if (messages.length === 0) {
     return (
-      <div className="flex flex-1 flex-col items-center justify-center px-4">
-        <div className="flex w-full max-w-3xl flex-col items-center gap-10">
+      <div className="flex flex-1 flex-col items-center justify-center overflow-y-auto px-4 py-8">
+        <div className="flex w-full max-w-3xl shrink-0 flex-col items-center gap-10">
           <h1 className="text-center font-semibold text-3xl text-balance tracking-tight sm:text-4xl">
             {t("chat.heading")}
           </h1>
diff --git a/frontend/lib/i18n/locales/en/translation.json b/frontend/lib/i18n/locales/en/translation.json
index b7ba111..24f4326 100644
--- a/frontend/lib/i18n/locales/en/translation.json
+++ b/frontend/lib/i18n/locales/en/translation.json
@@ -809,7 +809,21 @@
       "discarded": "Discarded — nothing was saved.",
       "addedTitle": "Added",
       "failedTitle": "Could not add",
-      "failedBody": "Something went wrong, or you don't have permission. Please try again."
+      "failedBody": "Something went wrong, or you don't have permission. Please try again.",
+      "batch": {
+        "title": "{{count}} records proposed",
+        "review": "Review & add",
+        "dialogTitle": "Review proposed records",
+        "dialogDescription": "Add them all at once, or remove any you don't want.",
+        "addAll": "Add all",
+        "adding": "Adding…",
+        "discardAll": "Discard all",
+        "newPatient": "New patient will be created",
+        "remove": "Remove",
+        "done": "Added {{added}} of {{total}}.",
+        "failedCount": "{{count}} failed",
+        "discarded": "Discarded — nothing was saved."
+      }
     },
     "lists": {
       "appointments": "Appointments",