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HIPAA Compliant Forms

At the heart of modern medicine is the need for accurate, timely clinical documentation. Collect patient histories, lab results, or medication lists using HIPAA compliant online forms.

At the heart of modern medicine is the need for accurate, timely clinical documentation. Collect patient histories, lab results, or medication lists using HIPAA compliant online forms.

Apply for a compliance plan

Compliance Features to Meet Data
Privacy Standards

EmailMeForm provides a user-friendly and secure platform for gathering and managing sensitive information, while also ensuring that you are in compliance with federal regulations.

Transmission Security

Patient data is safeguarded when transmitted electronically. Any sensitive information submitted through your form is transmitted as encrypted data using the industry standard SHA 256 SSL connection.


The technical safeguard standard mandates that patient data or PII should not be deleted or altered in an unauthorized manner. All data gathered through your forms is protected from unauthorized access by our secure cloud storage.

Person or Entity Authentication

Our security standards require proof of identity to access accounts that collect sensitive user information. EmailMeForm has MFA (multi-factor authentication), meaning it can only be accessed with a strong password and a unique code generated from authentication applications.

BAA (Business Associate Agreement)

EmailMeForm provides a BAA for your business to securely collect and store PII and PHI.

Field Encryption

Our forms provide an added layer of security for your practice. EmailMeForm uses encrypted fields to protect PHI, ensuring security and confidentiality from the moment users enter their data.

Audit Controls

Track all activities that occur to mitigate the risk that may happen. The "Audit Trail" on every form displays detailed logs of modifications made to your forms and the actions taken with your data.

Access Control

Add team members to your account and distribute permissions according to their specific roles.

Collecting PII or PHI

PII (personally identifiable information) and PHI (protected health information) are often used interchangeably. However, knowing the difference is crucial for any business meaning to achieve HIPAA compliance. PII includes general information that can be used to identify or locate an individual, while PHI refers to health-related information (medical records) . PHI is a subtype of PII acquired through the provision of healthcare services. EmailMeForm helps you meet the global compliance standards necessary to collect both PII and PHI.

Expand your business with
HIPAA compliance

Streamline the process of receiving clinical documents, making it faster, reliable, and completely secure. Your forms can be easily filled out by patients, doctors, and other healthcare professionals, and submitted electronically to our secure cloud storage.

Schedule Appointments Online

Accept online appointments by embedding your form on your website. All our forms are fully customizable with professional themes and brand logos.

Confirm Patient Schedule

Invite customers to pay online when making their appointment, reducing the possibility of no-show and streamlining their experience. Your form can integrate with payment processors or use Vault, a PCI certified solution to collect credit card payments—no need to hold down patients every after doctor appointments.

Create Registration Forms

Collect patient data with confidence. Mark required fields and encrypt sensitive health information. Add categorized pages into your registration forms and gather patient records in a fast and organized manner.

Restrict Form Access

Health records are accessible only with permission. Allow form access to specific team members and share form passwords with selected clients. Set a HIPAA standard password that includes two-factor authentication and strong identification to secure your account.

Get Informed Consent

Only perform legal and valid practices and ensure your patients sign their consent waivers with digital signatures. Your medical forms can be accessed from any device.

Receive Clinical Documents

With electronic records, you can keep track of patient health records and insurance documents easily and securely, and access them quickly when you need it. Simply allow your form to receive files.

Workflows for Healthcare Professionals

Gather patient information and protect your health-related business


Rose requires medical treatment.

She learned that your clinic specializes in treating her condition. Though miles away from your location, she finds your office online.

An EmailMeForm form used for patient registration.

She fills-out your registration form.

Rose fills out the new patient registration form. She sees your forms are HIPAA compliant, instilling her with confidence to submit her medical history online.


Your administration is notified.

You receive her appointment request and medical history. The new appointment is added to your calendar.


Rose is now scheduled.

An email is sent to her to confirm her booking. This is sent simultaneously to her and you as a clear copy of her new record.


After the appointment, Rose provides her credit card information.

Once the appointment is confirmed, Rose is invited to pay for her visit in advance. She can pay for the appointment once using a payment gateway, or she can authorize automatic payments for recurring appointments through EmailMeForm’s Vault, the PCI DSS certified way of collecting credit card information.

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Easy to Use HIPAA Form Templates

Create branded healthcare forms with the help of our professionals from CustomWorks

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Patient Intake

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Patient Medical History

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New Patient Enrollment Form

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Medical Consent Form

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Medical History Form


Frequently Asked Questions:

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulated by the U.S. Department of Health & Human Services is a federal law that protects the privacy and security of individually identifiable health information, also known as protected health information (PHI).

HIPAA key rules are the following:

  • HIPAA Privacy Rule - Standards that set the limit on the access of private patient records (personal information).

  • HIPAA Security Rule - Establishes national standards for the security of electronic PHI (ePHI) and requires covered entities to implement administrative, physical, and technical safeguards to protect ePHI.

  • Breach Notification Rule - Requires covered entities and their business associates to notify individuals and the Health and Human Services (HHS) in the event of a breach of unsecured PHI.

  • Enforcement Rule - Outlines procedures for investigating and enforcing the HIPAA Privacy, Security, and Breach Notification Rules. It gives the HHS Office for Civil Rights the authority to investigate complaints of HIPAA violations, impose penalties, and refer cases for criminal prosecution.

HIPAA compliance refers to the process of ensuring that covered entities and business associates are following the requirements of the HIPAA Privacy, Security, and Breach Notification Rules, including implementing policies and procedures to safeguard personal health information.

Entities in contact with PHI – health plans, healthcare clearinghouses, health insurance companies, health care providers who conduct any financial and administrative transactions electronically, and endorsed sponsors of the Medicare prescription drug discount card – are legislated by HIPAA. Additionally, Business Associates (BA) are also covered by the act.

HIPAA violation would damage your business’s reputation. Failure to meet these requirements regarding handling PHI and PII can incur fines to businesses up to $50,000 per offense up to a maximum of $1.5 million per year.

EmailMeForm complies with HIPAA. However, there is currently no HIPAA certification recognized by the US Department of Health and Human Services (HHS).

The short answer is yes. If you are collecting personally identifiable information (PII) or healthcare information you are subject to HIPAA or other data privacy compliance requirements.

Yes. You may enjoy a 14-day trial to enjoy a compliance plan. The plan includes HIPAA and other global compliance. Contact us for more information.

Please contact us for any concerns.

This page is for presenting our HIPAA compliance information only. We highly recommend that you consult
legal advice to further support your HIPAA Compliance obligation.

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