Submit Patient Forms

The rate in which you sign up is guaranteed to remain in effect for the length of your subscription regardless of your billing frequency (monthly or yearly).

You can change your billing frequency at any time via the management account you will have access to once you sign up for our service. The billing frequency will change immediately after the current period has ended. For instance, if you are changing from Monthly to Yearly, at the end of the current month (which you have already paid for) you will be billed for a year.

First, we ask that you read the terms and conditions of a subscription by clicking here. Subscriptions are for one year and will result in a $150 cancellation fee if canceled early (price effective June 1, 2009). If your subscription term is up, or if you want to cancel within 30 days of the end of your term, please send an email to info@submitpatientforms.com requesting that your account be terminated.

You can see a set of sample PDFs already filled out by follow this link.

Yes, the system allows for an unlimited number of forms. Your $995 conversion fee covers up to 12 pages of custom forms during the initial setup (price effective June 1, 2009). If you require more forms, you can get a cost estimate from us, which will depend on the number of additional forms and complexity of your request.

Submit Patient Forms’ generic forms are provided at no charge in Spanish. If you are interested in translation of custom forms into Spanish, there is an additional one time $350 charge (price effective June 1, 2009). Email us at support@submitpatientforms.com for specific requests.

Absolutely! We offer CUSTOM forms.

When you pay a conversion fee of $995 (price effective June 1, 2009), you get up to 12 pages of forms. If you require more forms, you can get a cost estimate from us, which will depend on the number of additional forms and complexity of your request. For instance, you may require separate Adult New Patient, Child New Patient and Emergency forms.

When you pay a conversion fee of $995 (price effective June 1, 2009), you get up to 12 pages of forms. If you require more forms, you can get a cost estimate from us, which will depend on the number of additional forms and complexity of your request. For instance, you may require separate Adult New Patient, Child New Patient and Emergency forms.

After you publish your custom forms, you can request changes via your management account. Depending upon the change, you will be given a quote to implement the change and we will wait for your authorization before we continue.

You can request custom forms during your signup process or anytime in the future from your management account. Once you agree to the low one-time conversion fee of $995 (price effective June 1, 2009), your account will be created and you will be asked to either send your custom forms via postal mail or via email (digital format). Once we receive your forms, conversion to our software takes up to two weeks. Once implemented, you will be notified that they have been uploaded into your account, and you will be given an opportunity to review them and make changes or corrections. Once you approve, you can publish your forms and begin using them.

YES! Now you can for a low one-time conversion fee of $995 (price effective June 1, 2009).

Unfortunately, this is not a service that we currently offer because of the encryption and security required.

It depends. If your software allows for importing PDF, JPEGs, Excel and Tiff, then yes.

Yes. You can and we will give you a choice of buttons and the HTML code to include on your site. If you are HTML-savvy you can do this yourself or you can deliver them directly to your webmaster and ask him/her to do it for you. With a link on your website, patients are directed to our site and they do not need to manually search for your practice in our directory. Instead, your practice is already selected and displayed for them when they arrive.

SPF’s works with a company that will provide electronic pads on which the patient can sign when they are in the office, and the signature is biometrically secured and bound to the electronic document.

At each recall appointment, have the office manager or assistant say, 'We would like to update your medical history and personal information. I just need your email address, and I will email you a link to our new online forms. Please complete them at your earliest convenience.' Then the office manager logs on to the practice management account and sends the patient an e-vite.

Because of our archival process, it depends upon when the patient was deleted and when the patient submitted the forms. Please contact support (support@submitpatientforms.com) with specific questions when this problem occurs and we will do our best to accommodate you.

Once a patient has completed their forms, they submit them and the doctor's office can see them. Until this time, the patient has not authorized the information to be submitted to the doctor's office.

Not directly. Have the doctor make a note in the chart or electronic EHR/practice management software [dated] with “ I reviewed the patient’s personal and medical/dental histories with ‘patient name.”

We do our best to ensure that email gets to its destination but unfortunately email is not perfect and the proliferation of SPAM means that SPAM filters are working in full force. You can tell a patient to watch for the coming email, to check their SPAM folders if they haven't received the email and to add the SubmitPatientForms.com domain to their Safe Senders List if their email client supports this functionality. Alternatively, you can provide a direct link (we will give you the HTML) from your website to the patient registration process.

Show your staff how it will save them time with less stress. Often, the office managers, assistants and hygienists have to interpret forms that are illegible, which slows down the process. Many offices have their staff retype the handwritten forms into the practice management software or scan the forms to save them, which is very time consuming. Our system always provides completed forms that are easy to read, and they can be downloaded in JPEG, PDF, Excel and Tiff formats with one click. Insurance eligibility and the patient's medical history can be verified before the patient arrives. Your staff can feel free to follow this link and see some test forms.

Yes. When a patient is sent an invitation to fill out the forms that you specify, their name will appear in the Patient Progress page within your management account. Here you can see the last time that you sent this patient an invitation, if the patient has responded by creating an account with SubmitPatientForms and how much of the form they have completed. From here you can send the patient a reminder to finish their form, if they are taking a while to complete it. Once the patient has submitted their form, their information will no longer be visible on the Patient Progress page but instead, their completed paperwork will be ready for download on the Registered Patients page.

Within the doctor's management account, we offer a Patient Progress Page which shows you the progress of forms being filled out. Any form that has not been submitted is listed on this page.

Forms can be downloaded in TIFF, PDF, Excel formats or as a ZIP file containing JPEGs of each page filled out.

Within the doctor's management account, we offer a Patient Progress Page which shows you the progress of forms being filled out. Any form that has not been submitted is listed on this page.

You will receive automatic email notification as soon as the patient clicks on "Submit." Then you can log on to retrieve the information.

You log onto your management account and with one click you download your patient's forms in either TIFF, Excel, PDF or JPEG formats.

We make these decisions on a case-by-case basis. Please feel free to email us at info@submitpatientforms.com with your proposal or request.

Yes we do, please feel free to read them here.

Yes we do; please feel free to follow this link and see some test forms.

We have a 30-day, money-back guarantee (must sign up for the monthly payment plan). If you do not like the service, you can notify us in writing (post office or email) before the end of the 30 day period, and we will refund your money and remove you from the system. This excludes offices for which we have provided custom forms. Once the 30-day period expires, you agree to subscribe to our service for one year. You may stop prior to the end of the agreement with a $150 cancellation fee (price effective June 1, 2009).

No. Our low monthly fee is actually the rental of our software and space on our ASP server. There is no limit on the number of patients you can have register.

I'm sorry but we are unable to make phone calls to your practice in order to answer questions. Instead, we ask that you send us an email at info@submitpatientforms.com. or to call us at 1.888.427.1116 or outside the US at 1.516.699.5588

If you can browse the web then you have the hardware you need. In fact, if you are reading this page, you are already set.

We ask that you contact us by email so that one of our support team can respond to you. Our email address is info@submitpatientforms.com. If you require a phone call, feel free to call us at 1.888.427.1116 or outside the US at 1.516.699.5588

We took the time to write a lengthy article about the security we provide, and we invite you to read it yourselves.

We are a division of WebDentalMarketing, a company that has been around for eight years. Learn more about the founders. Or if you have further questions to which you can't find answers, call us at 1.888.427.1116 or outside the US at 1.516.699.5588.

SPF’s 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.