HIPAA Compliant Registration Forms

Digital Forms

Collect patient information before visits, conveniently and accurately.

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Simplifying the form collection process for patients and providers

Offering digital forms to patients ahead of visits is a practical way to simplify the check-in process and save staff time from manually inputting patient data into their systems from paper forms. Our digital solution enables you to email or text patients, directly from your workstation, a link to registration and payment forms that they can fill out at their own convenience before their appointment.

  • Save patients time in the office by sending them forms to fill out in advance, instead of requiring them to arrive early to visits to fill out paperwork.
  • Create a contactless check-in process, instead of passing clipboards and pens back and forth.
  • Improve the accuracy of patient information by letting them input data themselves at their own speed, instead of rushing through forms.
  • Simplify data entry for your staff by uploading digital forms into your practice management system or electronic health record, instead of manually copying information from paper forms.
  • Collect payment information from patients ahead of time and place their preferred card on file for future payments, instead of waiting until after appointments to talk about payments.

Our digital forms are fully HIPAA-compliant.

Medical Registration Forms

Medical Registration Form

Take your intake process to the next level by providing the ultimate digital experience to your patients and staff. Our new digital intake forms allow patients pre-visit to submit their information which is an experience they love and expect in 2023. Staff love it because it saves hours each week, reduces errors in data entry, and minimizes storage costs.

Payment Authorization Form

Promoting a digital hands-free payment experience has never been more important than it is today. We have developed a payment authorization form that can be sent during any phase of care, pre-care, point of care, or post-care, to quickly and securely keep a card on file, or as we call it vaulted. It streamlines the operational workflows within the payment process making life easier for both patients and staff alike.

Payment Authorization Form
Medical Registration and Payment Authorization Form

Combined Form

Convenience with the click of a button. Our combined registration and card authorization form allows for the premier digital experience. Enabling patients to submit medical information and payment preference pre-visit ushers in that truly contactless experience and creates an environment of modernism at the practice.

58% of patients would switch providers if they were given the option to avoid tasks such as filling out forms in the office.1
Case Study

LWSS Case Study

Discover the transformational effect that our consultation and technology had across this dental organization’s offices.

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1Of 2,000 patients surveyed in The Healthcare Payment Experience, January 2021, produced by PYMNTS.com and Rectangle Health.