HIPAA-Compliant Contact Us Form For Patient Data
Do you only need a simple Contact Us form that’s HIPAA-Compliant? Sign up for HIPAAtizer and get a HIPAA Compliant Contact Form.
Why HIPAAtizer?
HIPAAtizer is the always HIPAA-Compliant form and document solution for healthcare practitioners and their developer and web agency partners. Don’t overpay for a simple HIPAA-Compliant form, use our simple to use and simple to install “Contact Us” template to get compliant.
You can customize the form, embed it on your WordPress, Wix, or Squarespace website and even edit the fields. Now you can safely collect protected health information, even at the earliest stage of a patient interaction.
Need help styling the template? Or, do you have your form you’d like to make HIPAA-Compliant?
Contact us or upload your form below
Some Features of HIPAAtizer’s Online Forms
HIPAA COMPLIANCE AND DATA SECURITY
Rest assured that your patient data is handled with the highest standards of security and in full compliance with HIPAA regulations, safeguarding the privacy and confidentiality of sensitive information.
BRAND CUSTOMIZATION
Elevate your brand experience by tailoring the visual aesthetics of your forms. HIPAAtizer allows you to customize your forms to match your brand’s unique identity.
INCLUSIVITY AND ACCESSIBILITY
Design your forms with inclusivity in mind, ensuring they meet accessibility standards for an experience that’s welcoming to all users.
Features available on our Gold Compliance and higher packages
EFFICIENT ELECTRONIC PAYMENTS
Simplify the process of collecting payments by adding Stripe or PayPal components to your online forms. Offer patients a secure and user-friendly payment experience.
SEAMLESS INTEGRATIONS
Effortlessly integrate HIPAAtizer with leading systems like WordPress, Wix, HubSpot, Google Sheets, Pipedrive, HighLevel, and more. Streamline your operations and centralize your data seamlessly.
STREAMLINED FILE UPLOADS
Enable patients to upload important documents or files, such as previous assessments or reports, directly through your online forms. Streamline the document submission process while keeping everything neatly organized.
Try HIPAAtizer’s Contact Form Today!
Want to convert your existing paper form into a HIPAA-Compliant online form? Upload your form below and HIPAAtizer will convert your form for free!