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HIPAA Compliant Forms

Simplify your intake process and protect patient information

Affordable & secure online medical and dental patient forms

With Practis Forms, it’s easy to streamline your patient intake or applicant process. Starting at only $25* per month, you can add patient intake forms, healthcare assessment forms and quizzes, online bill pay or patient consent forms to any website. We have many standard forms available or we can create any custom medical or dental form you need. Send us your patient forms and we take care of form set-up for you.

Key features you seek

  • Mobile-friendly, HIPAA compliant forms that can be completed from any device including desktop, tablet and phone.
  • Enhanced security, user access management, data export and more.
  • Forms are branded to match the look and feel of your website.
  • Supports e-Signature to capture signatures on your online forms.
  • HIPAA compliant file upload for medical reports, diagnostic images
  • WordPress plug-in available for easy installation.
  • Scoring to assign points to user results.
  • Conditional logic for an enhanced user experience.

Secure Medical Online Bill Pay

Practis Pay

Get paid faster with online bill pay.

Allow your visitors to securely pay online through your website. Practis Pay integrates with BluePay, a leading payment gateway for real-time payment processing.

Learn more >

 

Form Pricing

 

Tier 1


$25/month

  • Online Support
  • 1 form
  • 500 submissions per form
  • 25 fields
  • Unlimited Users
  • Unlimited Reports
  • Electronic Signature
  • reCAPTCHA
  • Accept Payments

 

 

 

Tier 2


$50/month

  • Online Support
  • Up to 3 forms
  • 1000 submissions per form
  • 150 fields per form
  • Unlimited Users
  • Unlimited Reports
  • Electronic Signature
  • reCAPTCHA
  • Accept Payments
  • Form Scoring*
  • Pagination

 

Tier 3


$75/month

  • Phone Support
  • Up to 6 forms
  • 1500 submissions per form
  • 250 fields per form
  • Unlimited Users
  • Unlimited Reports
  • Electronic Signature
  • reCAPTCHA
  • Accept Payments
  • Form Scoring*
  • Pagination
  • Accept File Uploads

 

 

 
dental form

Practis Quizzes

Online health assessments and quizzes are important tools for understanding your patient and employee’s needs.

These tools enable you to provide targeted information and solutions so that they can take action. Utilizing Practis Forms, you can now collect and score data. Whether you use quizzes for lead generation on your website and Facebook page, or internal needs like employee training, online quizzes can be a powerful part of your toolkit. Benefits include:

  • Create online health assessment forms and quizzes with no coding required
  • Data is scored within the secure application
  • All health assessments and quizzes are optimized for mobile
  • Practis Quizzes can be embedded to any website or Facebook business page

Starting at only $50* per month.

Sign-up Now! View Live Quiz View Demo Quiz

Convert your current pdf forms to online HIPAA compliant forms

With an easy embed option, your HIPAA compliant forms are securely integrated into your hospital, medical or dental website in the matter of minutes! 

Whether you’re trying to improve your patient intake process for your medical or dental practice, looking to engage users or needing to streamline hiring, our secure HIPAA compliant form builder has the flexibility to meet your changing needs.

Branded to match the look and feel of your website, Practis Forms has met the needs of hundreds of medical and dental practices, hospitals, healthcare, non-profit and financial organizations nationwide. With Practis Forms you can expect: 

  • Unlimited benefits. You can create as many forms as you need and add an unlimited number of users. 
  • Ability to export your data. Exporting your ePHI or sensitive data includes printing to pdf, downloading to an Excel or .CSV file format. This will allow you to import your data into into your internal system(s).  Soon, Practis Forms API will allow you to integrate your data to third party systems such as your EHR.
  • No long term contracts. 
  • BAA. When you sign up with Practis Forms, we sign a BAA with you.
  • Better user management. Allow multiple users to log-in to your account to manage submissions. The Form Administrator can manage their user’s access right through the dashboard. Based on specific user permissions, each email address (user) is assigned to view specific form. For example, front desk staff would have access to view appointment requests and medical records staff would access health history form results.

Sign-up Now! 

 

*Additional fees for account activation, file upload and scoring apply.