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:

Appointment forms

Set up appointment forms for patients to book a time slot without crowding the waiting room

Patient Registration

Add new patients to your registration process with ease.

Online Billing

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

Get advanced with it

Automate

Set up workflows that collect data while you do other stuff

Create Reports

Turn customer responses into data you can use to improve your events.

Get Notified

123 Form Builder notifies you, so you never miss an important message.

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