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HIPAA Compliant Forms

Securely collect patient information and easily digitize your workflows with confidence.

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Compliance Features to Meet Data
Privacy Standards

Create your business workflow and comply with data privacy regulations with our easy-to-use forms and survey solution.

Transmission Security

Patient data or PII is safeguarded when transmitted electronically. The protected information from your form transmits as encrypted data through industry-standard SHA 256 SSL connection.

Integrity

The technical safeguard standard mandates that patient data or PII should neither be deleted nor altered. The secure cloud storage of your form ensures security measures to prevent unauthorized approach.

Person or Entity Authentication

Require measures only to allow access based on identity proof. EmailMeForm has MFA (multi-factor authentication), meaning it can only be accessed with a strong password and a unique code generated from authentication applications.

BAA (Business Associate Agreement)

EmailMeForm provides a BAA for your business to securely collect and store PII and PHI.

Field Encryption

Imperative to protect PHI is proper encryption. Data is safe when stored and retrieved.

Audit Controls

Track all activities that occur to mitigate the risk that may happen. The "Audit Trail" on every form shows the revision details of who initiated the edit.

Access Control

The User Form Manager can allow multi-users but with defined permissions.

Collecting PII or PHI

PII (Personally Identifiable Information) and PHI (Protected Health Information) are often used interchangeably. However, there is quite a difference crucial for business meaning to achieve HIPAA compliance. PII includes general information that can be used to identify or locate an individual, while PHI is health-related information (medical records) disclosed. PHI is a cluster under PII obtained from providing healthcare services. With EmailMeForm, you can meet global compliance standards to collect PII and PHI.

Expand your business when your
form is HIPAA compliant

Keep up with the technological changes while saving your business from fines.

Schedule Appointments Online

Accept online appointments when you embed your form on your website. Let your patients connect with you quickly, with no personal interaction or phone trials. The appointment form can be customized with your themes like hospitals or healthcare logo.

Confirm Patient Schedule

While you accept online appointments, you can offer to process payments online for your patient to confirm a slot for checkups or consultations seamlessly. Your form can integrate with payment processors or use Vault, a PCI certified solution to collect credit card payments—no need to hold down patients every after doctor appointments.

Complete Registration Form

Collect your patient information online with confidence. Mark required fields for you to avoid missing out on essential items or mask sensitive patient data. Break registration forms into pages of different categories, so you gather their record neatly.

Restrict Form Access

Secure form access to selected members and share form password to selected clients. The health record is accessible only to those with permission. Set a HIPAA standard password that includes two-factor authentication and strong identification to secure your account.

Authorize Consent

Only perform legal and valid practices. Let your patients electronically sign their consents or waivers for any virtual transaction. Capture their official signature to minimize any legal misunderstandings. Your patients can forward their consent from anywhere since your medical form is mobile to access from anywhere.

Receive Clinical Documents

Do not lose patients who use health cards or insurance. As much as you favor physical compliance with these, some patient representatives can’t be present. Simply allow your form to receive files of any medical document or image.

Workflow Solutions with Your HIPAA-Compliant Forms

Gather patient information and protect your health-related business

Rose

Rose requires medical treatment.

She learned that your clinic specializes in treating her condition. Though miles away from your location, she finds your office online.

Rose

She fills-out your registration form.

Rose fills out your registration form for new patients. She sees your forms are HIPAA compliant providing confidence to submit her medical history online.

Rose

Your administration is notified.

You receive her appointment request and medical history. The new appointment is added to your calendar.

Rose

Rose is now scheduled.

An email is sent to her to confirm her booking. This is sent simultaneously to her and you as a clear copy of her new record.

Rose

After the appointment, Rose provides her credit card information.

Rose fills out your PCI Certified Vault form setup with EmailMeForm to give you a credit card authorization to settle her account and future visit with your paperless workflows.

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Easy to Use HIPAA Form Templates

Create branded healthcare forms with the help of our professionals from CustomWorks

Form cover

Patient Intake

Healthcare
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Patient Medical History

Healthcare
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New Patient Enrollment Form

Healthcare
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Medical Consent Form

Healthcare
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Medical History Form

Healthcare

Frequently Asked Questions:

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulated by the U.S. Department of Health & Human Services aims to improve healthcare services specifically on Personally Identifiable Information securing it against theft and fraud.

HIPAA key rules are the following:

  • HIPAA Privacy Rule - Standards that set the limit on the access of patient private records (personal information).

  • HIPAA Security Rule - Standards that set the required protection of electronically protected health information (ePHI).

  • Breach Notification Rule - Requirement to notify HHS when a data breach is identified.

  • Enforcement Rule - Sets the process of investigation that happened after the breach. Fines are issued if proven the investigation is conducted with negligence.

HIPAA compliance means that any health care providers and other entities dealing with protected health information (PHI) have security measures to provide safety from risks of healthcare data violation.

Entities in contact with PHI – health plans, healthcare clearinghouses, healthcare providers, and endorsed sponsors of the Medicare prescription drug discount card – are legislated by HIPAA. Additionally, Business Associates (BA) are also covered by the act. These are entities that have no direct operations related to PHI but provides services with access to PHI.

HIPAA violation would damage your business’s reputation. Failure to meet these requirements regarding handling PHI and PII can incur fines to businesses up to $50,000 per offense up to a maximum of $1.5 million per year.

EmailMeForm complies with HIPAA, however, there is currently no certification of HIPAA recognized by the US Department of Health and Human Services (HHS).

The short answer is yes. If you are collecting Personal identifiable data (PII) or disclosing healthcare information you are subject to HIPAA or other data privacy compliance requirements.

Yes. You may enjoy a 14-day trial to enjoy a compliance plan. The plan includes HIPAA and other global compliance. Contact us for more information.

Please contact us for any concerns.

This page is for presenting our HIPAA compliance information only. We highly recommend that you consult
legal advice to further support your HIPAA Compliance obligation.

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