Website Design & Development
HIPAA-compliant patient intake forms.
Replace paper, PDFs, and emailed attachments with secure online forms that patients can complete on any device, branded to match your site, with a Business Associate Agreement included.
Paper intake is a risk, not just a hassle
Most healthcare organizations still collect patient information the way they did twenty years ago: a clipboard at the front desk, a PDF the patient prints at home, or worse, an attachment emailed back and forth. Every one of those is slower than it needs to be, and the emailed version is a HIPAA exposure waiting to be found.
Secure online forms fix both problems at once. Patients complete intake before they arrive, on their phone, and the information lands somewhere encrypted instead of in an inbox. Your front desk stops retyping handwriting, and your compliance posture improves rather than degrades.
What the forms do
Access
Completed on any device
Mobile-first forms that work on a phone in the parking lot as well as a desktop at home, so patients actually finish them.
Security
Encrypted and access-controlled
Submissions are encrypted, and you decide which staff can see which forms. Permissions are managed per user from your dashboard.
Brand
Branded to your site
Forms match the look and feel of your website rather than looking like a bolted-on third-party tool that patients hesitate to trust.
Signatures
Electronic signature
Capture consent and authorization signatures on the form itself, so nothing needs printing, scanning, or chasing.
Uploads
Secure file upload
Patients can attach insurance cards, referrals, and prior medical reports without emailing protected health information.
Logic
Conditional logic and scoring
Show only the questions that apply, and score answers automatically for assessments and screening.
From PDF to live form
Send us your current forms
Whatever you use today, paper scans or PDFs. We convert them, including the ones with awkward tables and signature blocks.
We build and brand them
Rebuilt as secure online forms styled to your site, with the conditional logic and scoring your workflow needs.
Embed them anywhere
Drop them into your website with a simple embed, or install the WordPress plugin. They also work on a Facebook business page.
Collect, review, export
Submissions arrive in a secure dashboard. Export to PDF, Excel, or CSV to move data into your practice management system.
Three ways organizations use this
Intake
Patient intake and consent
New patient registration, medical history, HIPAA acknowledgements, and treatment consent, completed before the appointment.
Assessments
Health assessments and quizzes
Scored self-assessments that help someone recognize they should be seen, and give you a qualified enquiry instead of an anonymous visit. They run on your site or a Facebook business page, and are a genuinely effective lead source for hearing, aesthetics, and behavioral health.
Payments
Online bill pay
Let patients pay securely through your website, processed in real time through an established payment gateway, so your team spends less time on the phone chasing balances.
Capability tiers
Choose based on how many forms you need and how much they need to do. Every tier includes unlimited users, unlimited reports, electronic signature, spam protection, and payment acceptance.
| Essential | Standard | Advanced | |
|---|---|---|---|
| Forms included | 1 | Up to 3 | Up to 6 |
| Submissions per form | 500 | 1,000 | 1,500 |
| Fields per form | 25 | 150 | 250 |
| Users and reports | Unlimited | Unlimited | Unlimited |
| Electronic signature | Yes | Yes | Yes |
| Accepts payments | Yes | Yes | Yes |
| Form scoring | No | Yes | Yes |
| Multi-page forms | No | Yes | Yes |
| Patient file uploads | No | No | Yes |
| Support | Online | Online | Phone |
The compliance part, in writing
We sign a Business Associate Agreement with every forms customer. Not as an upsell, and not only for the enterprise tier.
There are no long-term contracts, you can create as many forms as your tier allows with an unlimited number of users, and your data stays exportable. If you ever leave, you take it with you.
This platform has handled intake for hundreds of medical and dental practices, hospitals, non-profits, and financial organizations nationwide.
Questions about secure patient forms
Are online patient forms HIPAA compliant?
They can be, but only if the whole path is built for it. A generic form builder that emails you the submission is not compliant, because protected health information ends up in an inbox that was never designed to hold it. Our forms encrypt submissions, control who can see them, keep data inside a secure application rather than email, and come with a signed Business Associate Agreement.
Can you convert our existing PDF patient forms?
Yes, and that is how most organizations start. Send us what you use today, including paper scans, and we rebuild them as secure online forms branded to your site. Awkward layouts, signature blocks, and multi-page histories are all normal.
How much do HIPAA-compliant patient forms cost?
It depends on how many forms you need, how many fields and submissions each one handles, and whether you need scoring or file uploads. It is a monthly subscription rather than a large project cost, and it is one of the least expensive things an organization can do to reduce compliance risk. Tell us what you collect today and we will tell you exactly what it costs.
Do you sign a Business Associate Agreement?
Yes. Every forms customer gets a signed BAA, at every tier.
Can patients sign forms electronically?
Yes. Electronic signature is included in every tier, so consent and authorization forms can be completed and signed without printing anything.
Can patients upload insurance cards and medical records?
Yes, on the Advanced tier. Secure file upload lets patients attach insurance cards, referrals, and prior reports without sending protected health information over email.
Will the forms match our website?
Yes. Forms are branded to your site's look and feel, which matters more than it sounds: patients abandon forms that look like they belong to a different company.
Can we take patient payments through our website?
Yes. Online bill pay processes payments in real time through an established payment gateway, so patients can settle balances from the same site they book on.
Get intake off the clipboard.
Tell us what your patients fill in today and we will show you the secure version, branded to your site.