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Custom, Secure Patient Forms


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We make extra efforts to ensure that all the text and form fields are very legible and large enough for easy viewing. We’ll rearrange the flow of the form (if necessary) to make it more logical and easy to understand. We’ll even rewrite some of the language of the form if it can help the patient complete it more accurately.

A significant number of our forms are new designs – just indicate what you want it to say and we’ll organize it and build it into an attractive, workable format. And there’s no additional charge.

We’ll include your logo at the top of each form, and the web address for each form will include your company’s name – example:

We’ll be happy to look at your situation, and can usually provide discounted development fees based on volume. Please contact us for more information.

We’ll be very happy! Then we’ll send our standard contract (no required time frame), and after you’ve sent us the info on the form you’d like us to design or rebuild we’ll email you a proof of the form for your approval. Once the design is finalized, we'll upload the form to our server and give you the URL to add it to your website. < more info

You’ll get an immediate notification to the email address(es) of your choice, which will include a link to our secure server. After entering your username and password, a PDF of the submitted form will be displayed (as well as all earlier submissions in the last 30 days).

All the PDF files we create for you will be stored on our server for 30 days - if you need to retrieve one you just need to log into our system and download it.

You’ll will be required to register with our system to be able to receive both notifications of form submittals and the submitted forms themselves. Once a patient makes a submission, an encrypted notification email is sent to the registered user that includes a link to the submitted form.

Upon clicking the link and logging in with the username and password that you selected during registration, you’ll see a list of all forms submitted in the last 30 days. A click on any item in the list will open a backfilled PDF.

The user’s password is not revealed to or accessible by anyone in our operation or the personnel at our secure server facility.

We’ve found the easiest way to handle online payments is through PayPal® – they can process a payment through any major credit card or through their own service. There's no need for you to establish a payment gateway through your bank or credit card company, and PayPal handles all necessary security for the transaction.

The funds will be in your PayPal account (minus PayPal’s nominal processing fee) very quickly. You’ll need to have or open a (free) PayPal Business Account. We’ll create the Pay Now button and add it to your form.

We go through and rebuild every bit of your form, field-by-field and line-by-line (and then build it again to create the PDF that you’ll see eventually), so almost all our effort is related to the content of each page, not the entire form.

For large, multi-page forms, pages that are all text and can be built with a simple cut-and-paste are included at no charge.

Organizations with a substantial number of forms may receive a quantity discount based on our ability to reuse repetitive elements from form to form – please contact us for more information.

We’ll send an invoice when your form is completed and running on our server, and then bill (for hosting only) every year thereafter.

Nothing!  We’ll update your forms at no charge whenever small changes occur. A request for a complete redesign may incur some additional cost – please contact us for more information.

Not long at all – we’ll usually have a proof of your form available within a few days, and the form will be up and running within a few days of your approval of the proof.

They’re usually done the same day.


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