123FormBuilder for Healthcare
Become the go-to healthcare provider that patients trust.
Start with HIPAA-compliant online forms.
Healthcare Providers that Count on 123FormBuilder
User-friendly forms, eSignature, easy to share
Be where your patients are, online
From patient intake to treatment plans and patient feedback, use our medical forms to optimize patient movement through different stages of care. Have your patients fill out online forms, digitally sign them, and send their data right back to you, so you can reduce patient wait times and improve care delivery.
Specially built for medical staff
Automate any healthcare workflow
Collect, share and manage patient data with better accuracy. Leverage the power of automated data collection to design workflows that give you real-time operation visibility and boost staff efficiency. Through flexible user management, integration with Salesforce, and customized notifications, you’ll increase collaboration and ensure a seamless flow of patient data across departments.
Industry compliances: HIPAA, GDPR & more
Securely collect sensitive data
Strike a balance between staff productivity, quality care, and data security with our HIPAA-compliant medical forms. Add the GDPR, CCPA, and COPPA compliance to advance your security level to manage PHI stress-free, remain compliant, and have complete control over your data.
Dedicated HIPAA-Compliant Medical Form Templates
An extensive gallery of pre-built HIPAA-compliant online form templates to help you get started. Choose yours.
Medical Release Form
Receive authorisation from patients or their legal guardians to share the patient’s information with other parties before providing any treatment.
Medical History Form
Use this medical history form template at your clinic to gather patient medical information faster
Medical Records Release Form
Add this medical records release form template to your website with 123FormBuilder.
Online Bill Payment
Share this online bill payment with your patients to improve your medical services
Medical Authorization Form
The medical authorization form can be used by a patient, or a caregiver of a patient, and signed to give permission to a doctor to conduct a medical procedure
Dental Treatment Consent Form
The dental treatment consent form template is a written authorization signed by patients about to undergo dental procedures
Applications & Workflows in Clinics and Hospitals
Configure your patients’ medical workflow by collecting their data for fast patient onboarding, screening, or recording billing information. Replace paper-based processes with HIPAA-compliant digital forms that lower patient wait time.
eSignature for Documents
Whether you need a signature from your medical staff or your patients you can quickly collect their electronic signatures by adding an extra field to your form. Create an error-free process and avoid delays in critical decisions.
Secure Medical Data
Whether you need to obtain consent to release medical records or share your patient’s data with another healthcare provider, our HIPAA-compliant and GDPR-friendly medical forms can help you remain compliant at all times.
Provide a great patient experience by proactively collecting feedback about your healthcare facility. Send online surveys to your patients to learn about the quality of your services. Allow them to send in their fresh thoughts from any digital device within minutes.
Bring visibility into daily operations; automate HR workflows for employee onboarding, administrative assistance, sales contract reviews, etc. Empower your staff to manage the clinic’s activity efficiently.
Insurance & Billing
Create automated billing workflows and streamline the process of insurance claims and payment collection. Collect essential information, keep track of data, notify all parties, and receive payments on time.
Integrate With 80 + Tools to Handle Data Without Interruptions
Create forms and collect leads to any object in Salesforce.
Create and publish forms directly on your Wix site.
Build forms, surveys or quizzes for your WordPress site.
Send form entries to Google sheets through submissions.
Build awesome forms for your eCommerce directly on Shopify.
Receive payments in your Square account through form submissions.
Streamline payments from your order form to your PayPal account.
Send file uploads to your Dropbox account after each form submission.
What It’s Like to Work with Us
We were able to provide a cost-effective HIPAA-compliant solution for forms for our clients. Everyone I work with at 123 has been wonderful and always responsive, which is important when it involves forms which can directly impact clients’ leads and revenue sources.
Lead Prodcut Manager at MDprospects
What It’s Like to Work with Us
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