HIPAA Compliant Online Forms

Always pick the secure way to handle patient information.
Collect PHI online with our HIPAA-compliant form builder.

Healthcare Organizations that Trust Our HIPAA-Compliant Form

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Secure, compliant healthcare

Deliver better care with HIPAA compliance

Patient data safety becomes your responsibility when patients share personal or medical information with you. So you want to partner with reliable platforms with the same level of commitment to data protection. 123FormBuilder proudly holds the HIPAA seal of approval that ensures we maintain the highest data privacy and security standards.

Whether you collect data for patient onboarding, run feedback surveys or clinical trials – you’re dealing with Protected Health Information (PHI) which calls for HIPAA compliance to make data collection safe and secure. With HIPAA-compliant online forms, practitioners and healthcare staff can easily collect patient information and consent for appointments, prescriptions, payment requests, patient intake, and much more.

Mobile-friendly and customizable

Build flexible, easy-to-use HIPAA forms

Although HIPAA compliance bears a heavyweight when it comes to patient data security, using HIPAA-compliant forms to collect and handle PHI doesn’t have to be complicated. With our drag-and-drop HIPAA-compliant form builder, you can quickly build, customize and share online forms with your medical staff and patients. Once shared with them, your patients can easily fill in your forms on their mobile devices, sign, upload files, and submit them with just a few clicks. And you don’t need any technical skills or coding to do that.

You can connect the forms to apps like Google Calendar to schedule appointments, MailChimp to send registration confirmation emails, Salesforce to automate your medical workflows, or PayPal and Stripe to collect payments. With online HIPAA forms, 123FormBuilder aims to help you eliminate manual processes and reduce patient wait times without compromising security or convenience. 

Data encryption, BAA & more

Count on enterprise-level security protocols

Along with our HIPAA compliance, you access a rich list of security measures that add extra protection layers to the data that moves through our forms. These extended security protocols help you avoid data breaches, mitigate risks, and always stay in control of your data.

  • Custom BAA and Confidentiality Agreements
  • AWS Data Residency (US, Europe)
  • 256 Bit SSL Encryption (on all forms)
  • Data Encryption (at rest & in transit)
  • User Roles & Permissions
  • GDPR, COPPA, CCPA Compliance
  • ISO 9001 & ISO 27001 Certifications

On top of these, you’ll always have someone to guide you along the way. Our knowledgeable support team and your Dedicated Account & Technical Manager will ensure you get the most value from 123FormBuilder.

Handling Healthcare Workflows with HIPAA-compliant Forms

Obtain patients’ permission for any upcoming medical procedure or treatment. Add an electronic signature field on your consent forms to legally bind it.

Streamline Patient Onboarding

Welcome new patients efficiently and reduce their wait time by collecting personal & medical data through HIPAA online forms. Send email confirmations and provide peace of mind.

Accept Bill Payments

Through 123FormBuilder’s HIPAA forms, you can give your patients a convenient & secure way to pay medical bills. Integrate with payment providers such as Stripe, PayPal, Square & more.

Improve Sales & MKT

Collect feedback, run lead generation campaigns, automate product requests, or simplify the sales contract review process with 123FormBuilder’s HIPAA-compliant online forms.

Run Clinical Trials

Optimize clinical research operations and minimize the human error associated with manual paperwork by using HIPAA forms online to enroll patients and collect their consent.

Manage Medical Records

Accurately collect and store the patient’s medical data in your online system, so you can quickly access any medical record and improve your staff’s response time.

Pre-built HIPAA Form Templates You Can Use Right Away

Start your HIPAA form from a template and immediately receive receiving PHI

Medical Release Form

Receive authorization from patients or their legal guardians to share the patient’s information with other parties.

Medical History Form

Use this medical history form template at your clinic to gather patient medical information faster.

Medical Authorization

The medical authorization form can be used by a patient, or a caregiver of a patient, and signed to give permission.

Dental Treatment Form

The dental treatment consent form template is a written authorization to undergo dental procedures.

Integrate with 3K + Popular Tools to Handle Data without Interruptions


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Allows end users to integrate the web applications they use and automate workflows..


Receive payments in your Square account through form submissions.


Streamline payments from your order form to your PayPal account.

What It’s Like to Work with Us

On the HIPAA compliance topic, we had the BAA and other well-known practices that helped us build trust. Also, additional security protocols are available in the platform, together with the dedicated onboarding session included in the license. Considering the fast-paced nature of the process and uncertainty in the timing for the vaccine approval, knowing that the data collection is safe and easy gives us peace of mind.

Jessica Beaty,

EMR & Training Manager at Village Health Partners.

What It’s Like to Work with Us


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HIPAA-compliant Server Requirements

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We’d love to show you what 123FormBuilder can do for you.