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Secure, HIPAA
Compliant Forms
Build HIPAA compliant forms in minutes. Drag-and-drop your way to a form that is easy for patients to fill in, and complies with regulations.
Thanks to COVID-19, the need to securely collect medical data has never been more pressing. But thanks to 123 Form Builder, everything is easy to build, secure, and automated.
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Trusted by over 35,000
companies including:
Set up appointment forms for patients to book a time slot without crowding the waiting room
Add new patients to your registration process with ease.
Issue medical invoices and collect payments seamlessly by connecting your form to your preferred payment provider.
Data collection just got HIPAA
- HIPAA compliant, certified, secure forms
- Custom BAA and Confidentiality Agreements
- Customize notifications
- PHI Protection
- 256-Bit SSL Encryption on all forms
- HIPAA compliant, certified, secure forms
- Custom BAA and Confidentiality Agreements
- Customize notifications
- PHI Protection
- 256-Bit SSL Encryption on all forms
- Data encryption at rest
- HTTPS Login and Automatic
- System Logoff
- 24/7 uptime, guaranteed
- Free training for your team
- 24/7 Dedicated Support
- Data encryption at rest
- HTTPS Login and Automatic System Logoff
- 24/7 uptime, guaranteed
- Free training for your team
- 24/7 Dedicated Support
Top healthcare providers use 123 Form Builder to securely power their workflows
Now it’s easy for staff to create forms that collect the exact information that the department needs.
Nelson Grillo
AVP Marketing Analytics
123 helped us through all of the setup process and attended to our concerns with speed and accuracy. These guys are lifesavers.
Ashley Rice
Chief Administrative Office, New England Vascular Access
Get advanced with it
Set up workflows that collect data while you do other stuff
Turn customer responses into data you can use to improve your events.
123 Form Builder notifies you, so you never miss an important message.