Click here to go Secure HIPAA Home PageClick here to go to the Menu of Available FormsClick here for the FAQ and Cost of the Forms ServiceClick here if you have questions about the serviceClick here to subscribe to the secure online forms service




Questions and Answers

Secure Online Patient Forms Service

Pricing and Demonstration

How do your patients access your patient forms?

How do you get the information after a patient has filled out one of your forms?

Do you need a website in order to use these secure patient forms?

How much does the service cost -- and what all does it include?

Who provides the questions that are on your patient information and health history forms?

How long will it take to get set up and have your forms online, ready for patients to use?


Can I load my patient's responces on the form directly into the patient software program that I use in my office?

Are the services provided by SecureHIPAA.com certified as "HIPAA compliant"?

How do you get started using secure online patient registration?




















Click here to go back to the top of this page. How do your patients access your patient Forms?

There are two ways that your patients can access your forms.

(1) You can direct new patients to www.SecurePatientRegistration.com. All they have to do at is enter your phone number to go directly to your secure forms.

(2) If you have a website, a link to your forms can be placed there -- in any location that you choose. We will give you the source code for the link and instructions how to make it functional........ (and patients can still enter your phone number at either site listed above.)


Click here to go back to the top of this page. Do you need a website to use Secure Patient Registration?
No, you don't have to have a website. When new patients call your office for an appointment, your can instruct them to go to SecurePatientForms.com or SecurePatientRegistration.com and enter your office telephone number. That will take them directly to a menu of your secure patient forms. If you have a website, your forms are created to reflect the design of your web pages.


Click here to go back to the top of this page. How do you get the information after the patient has filled out a form?
When a patient has completed one of your forms and has submitted the information, you will receive an email alerting you to that fact. You then log in to your account at SecureHIPAA.com and download the information . . . or, you may designate a member of your staff to be in charge of this function. The designated staff member should be approved by your HIPAA Privacy Officer.

Your will have up to five usernames and passwords for your account (more are available if needed). One is the 'main username and password' and you should keep that idenity for yourself and not divulge it to any member of your staff. The others may be assigned to staff members for the purpose of retrieving the patient forms. If a password is lost -- or if a staff member who has had access to one of the passwords is terminated for any reason -- you should change the password for that username immediately.

If you need it, you will be provided with a secure web based email account where the notifications will be sent. This is included in the subscription fee so that you don't have to share your personal email account with staff members.


Click here to go back to the top of this page. How much does the service cost --- and what all does it include?
The secure online patient form service is only $49.50 per month (if paid annually) for the first doctor in a practice and $20.00 per month for each additional doctor. The registration form used by the practice will be personalized for each doctor and each doctor will have his/her own personal notifcation service, control panel and separate database. Additional discounts are available for over 5 doctors or a hospital. This low all inclusive price makes the convenience of having the patient forms easily affordable for even a small practice. There is no setup fee (if paid annually) and you have unlimited access and use of the forms.

In addition to the secure Patient Registration and Health History forms, the SecureHipaa.com online patient form service also includes your online Notice of Privacy Practices and Phone number access at both SecurePatientRegistration.com and SecurePatientForms.com. Instructions are provided so that you can place a link to the automated secure forms on your website (if you want to). Our service also includes our automated Patient Registration Notification service (with a free secure email account for you or your office staff if you need it) and a secure control panel for accessing your patient registrations.

After you subscribe, a SecureHIPAA staff member will contact your Privacy Officer or Office Manager to coordinate the setup and activation of your forms.

We accept Mastercard, Visa, Discover and American Express credit cards. If you prefer, you may mail us a company or personal check. We will trust you and start preparing your forms as soon as your online subscription is received.


Click here to go back to the top of this page. Who provides the questions for the patient registration and health history forms?

You send us your forms via our toll free fax, postal mail or email. You may add questions that you would like to have that are not included on the forms that you are using now -- and mark out any questions that you want to exclude. Or you can choose from our existing array of forms.

We adapt your forms to make them 'web enabled' and 'patient friendly'. Everything is secure and HIPAA compliant.


Click here to go back to the top of this page. How long will it take to get set up and have your forms online, ready for patients to use?
Depending on the number and size of your forms, they will be programmed and activated within 6 to 10 business days from the day you have given us the questions you want on your forms and have approved the format of the forms.


Click here to go back to the top of this page. Can I load my patient's responces on the form directly into the patient software program that I use in my office?
Yes, there are a number of industry standard formats for data import from an ascii file and as long as your patient software program uses one of them we will provide a download of the patient's file in the prescribed import format of your patient software program at no additional cost.


Click here to go back to the top of this page. Are the services provided by SecureHIPAA.com certified as "HIPAA compliant"?

We certify that our services are HIPAA compliant. However, no enity is"certified" by the government. HHS and OCR do not endorse any private consultants' or education providers' seminars, materials or systems, and do not certify any persons or products as "HIPAA compliant." Please refer to this page for full clarification. http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/misleadingmarketing.html


Click here to go back to the top of this page. How do you get started using secure online patient registration?
Click here to sign up!



































********************