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

no-more-exporting — **Patient Registration**

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