The SecureForms for the Medical Industry

At SecureForms, we know your time is valuable. The last thing you want you or your staff to worry about is how to build and manage forms, receive incomplete faxes, and do twice the amount of follow-up work day after day. With a low flat-rate monthly subscription, we build out your forms, update forms, protect and process your confidential form data.

The following forms integrations are available:

  • New Facility Registration
  • New Patient/Resident Enrollment
  • RX Refills (Second Dose)
  • Patient Billing / Responsible Financial Party
  • Custom form design/implementations are available upon request

Medical Secure Form benefits:

  • Customized with your organization’s branding
  • Custom fields can be added as desired
  • Fields can be pre-filled with information to speed up the entry process
  • Available to embed into your website on a public or protected page
  • Send as hyperlinks (especially useful for ‘Financially Responsible Party’ form information and signatures)
  • Required fields and formats help prevent incomplete submissions which greatly reduce follow-up customer service interactions

We are here to help!

Contact us to learn how SecureForms can help you save patient on-boarding time and provide a higher level of customer satisfaction.

Schedule a call with a forms specialist to learn more of how SecureForms enhances your customer service and saves money.

Give us a call for general questions, comments, or just to get started with SecureForms. Our staff is informed and happy to assist you.

Phone: +1 800-514-5908

Email: Email Us

Frequently Asked Questions

The SecureForms are hosted on dedicated HIPAA certified servers.  The data collection on the forms is encrypted over SSL.   2-Factor Authentication can be enabled for clients that want it implemented.

Once the signup/registration has been completed, our customers are typically up and running the same day.

No download required.  These forms can be accessed via any web browser, smartphone or tablet.  The forms can be embedded into corporate websites, or hyperlinks can be shared via email or text messaging to provide access to the forms.

The forms can be modified with your company’s logo, fit your website branding, color scheme, etc.

The New Facility, New Patient, Responsible Party and Prescription Refill Orders are already part of the SecureForms Gallery that is integrated with DocuTrack.  We can add any custom field(s) to these existing forms or develop custom data collection forms for DocuTrack’s clients.

A user can fill out a SecureForm using their smartphone, computer or tablet, wherever they are.  A PDF version of the completed form is automatically routed into your client folder within DocuTrack.  A secure, password protected PDF file of the submission can be emailed to your administrators and/or copied to the submitting part.  Indexed information on the forms automatically populates the key fields within DocuTrack.  If you have selected an additional software integration, the information collected via the SecureForm will automatically create/populate the records in your pharmaceutical system.

  • There are no hardware, development or infrastructure costs.  It is quickly and easily implented via a 100% managed HIPAA-compliant Software as a Service (Saas).
  • Multiple front-line workers can conveniently submit form data 24 hours a day using their smartphone or tablet.
  • Returning users can have their own information pre-populated which saves on data entry time.
  • Required fields on the forms ensure complete submissions and our customers save a tremendous amount of customer service time not correcting inaccurate information or chasing down missing data.
  • Our customers are charged on a per-submission basis instead of on a per-faxed-page basis.

What Our Clients Say

Kind words from an early adopter

“Extraordinary Time Saver!”

Previous issues included error-prone and incomplete fax communications, requiring our staff to spend significant time going back and forth with calls and emails to gather needed information.

With SecureForms we’ve realized significant benefits:

  • With SecureForms, our staff can more efficiently complete the onboarding process. Information arrives complete due to required form fields, which also enhances the customers’ experience as a whole.
  • SecureForms has provided an unexpected bonus of streamlining and improving our client acquisitions through the after-hours New Facility enrollment capabilities.
  • We experience significant tangible and intangible savings and benefits of using SecureForms and we expect that these will increase as time continues.

Pharmacy, West Coast