Online Patient Forms

Electronic Forms for Health Professionals

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SubmitPatientForms provides health care facilities the capability for their patients to fill out their HIPAA acknowledgment, personal/ insurance information and medical histories online.

The practice receives the information before the patient’s visit and can validate insurance coverage and red-flag any medical problems.

“I appreciate your service and your integrity.” - Robert L Nelson, DDS
“Worked like a charm, thanks for the prompt reply...great service. Completing the 'New Patient Form' while drinking coffee in the comfort of your home is not a bad experience at all.” - Luisa K. (Patient)
“We love SPF because it costs us less than half of traditional paper forms with postage requirements. It also makes our schedule flow well, because we don't have to wait for patients to fill out paperwork at the beginning of each appointment.” - Robert L. Wood (Office Manager) Pittsburg, KS
"We have been extremely satisfied with the introduction of online patient forms into our practice. Having these forms completed in advance makes it possible for us to prepare patient charts and confirm insurance information before scheduled appointments. Eligibility, which has often been a problem in the past, has been eliminated by use of the forms. Most patients like being able to do these forms at their leisure. I would highly recommend Submit Patient Forms.” - Susan Tomkin, Office Manager Chelsea Eye & Cosmetic Surgery Associates New York, NY
"Our Patients love it! What a great way to minimize paper and time all at the same time! These days, people live for convenience!" - Jason D. Lewis, DDS, Bartram Dental Center St Johns, FL

Illegible handwritten forms could lead to serious mistakes – what if a patient’s medication or allergies are not readable or mistyped into the EHR? With Submit patient Forms, all information is received clearly printed and easy to read. About 100,000 Americans die from medical errors in hospitals every year. Source: Linda T. Kohn, Janet M. Corrigan, and Molla S. Donaldson, Editors; Committee on Quality of Health Care in America, Institute of Medicine (2000). To Err is Human. Washington, DC: National Academy Press.

Almost every Electronic Health Records manufacturer emphasizes that your practice must become paperless to meet the government’s directive of lowering heath care costs and minimizing mistakes. However, they suggest that in order to become paperless, the health care facility must retype all the information provided by the patient on handwritten forms into their EHR or scan all the forms. SubmitPatientForms provides the missing link and first step to a paperless practice.

Submit Patient Forms gives health care providers an Internet presence, whether or not the practice has a website. When the patient clicks on the forms’ link sent by the office, they will navigate to a page with the practice name and logo as a banner, while actually, they have not left our secure server. The patient’s perception will be of hi-tech capabilities on the doctor’s own website. This will create a powerful branding effect and marketing tool for the practice.

Reduce Your Administrative Costs

"One quarter of all medical spending goes to administrative and overhead costs and reliance on antiquated paper-based record and information systems that needlessly increase these costs."

Source - Woolhandler, Terry Campbell, and David U. Himmelstein (2003) "Costs of Health Care Administration in the United States and Canada." New England Journal of Medicine.


The average dental practice spends upwards of $15,800 on the creation and storage of patient charts each year and spends at least $11,520 annually on 576 hours of labor requited to maintain paper records.

Source - Dr. Larry Emmott. Paper vs. Digital: What's it Worth to You? Dental Products Report, 01-JUL-2006.

Can I use my own forms?

We can convert your forms to our software incluiding logos and graphics offer customization of practice forms online for a low one-time conversion fee of $995. Regardless of the type of health vare practice you have, you ask the questions you want of your patients and receive their answers in a secure manner.

New Legislation

On February 17, 2009 President Obama signed into law The American Recovery and Reinvestment Act of 2009, providing $19 billion funding for health information technology such as Electronic Health Records [formerly know as Electronic Medical Records]. Section (3) (a) (ii) States, “Plan to include specific objectives, milestones, and metrics with respect to the following: The utilization of an electronic health record for each person in the United States by 2014.”

What does it mean to be HIPAA compliant with a website?

Submit Patient Forms has two levels of protection built into its system. Here’s one scenario: Six months down the line, the patient says, “You asked me for all this personal and medical information, but you never advised me of my rights.” Until the patient clicks on “I Accept” at the end of the HIPAA document, the first screen they see, they cannot see or fill out any other forms. When the electronic forms are completed, they are digitally recorded with the Date, Time of day and IP addresses [computer the patient was using] at the bottom of page. Secondly, no personal information is sent in an email that could be intercepted (it is uploaded onto our secure website), so the practice is protected. HIPAA rules recommend that electronic transfers of personal health information and access to it are protected by encryption and authentication. SPF’s service meets those standards.

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