Your entire team may be added to receive copies of forms as they are completed by customers.


Forms are easily converted to a PDF or Database, and for longer forms add our 'Save & Return' button!


Is it legal?
Yes, not only is it legal binding document but is also one of the most secure ways to transfer protected health information – in a full encrypted transit and HIPAA compliant system. Mediprocity will also provide you with a custom legal box which allows your legal team to add in language that your users accept as a terms and conditions.  Mediprocity can even provide you a legal template to help you get started.

How do Secure Forms work?
Paper forms are transformed into secure web links that can be sent to ANYONE, anywhere. Your clients click on the links you provide, complete and submit your forms online and secure documents are sent immediately via Mediprocity to one or more recipients in your organization.  Personal data is validated and protected.

Can we use our own forms?
Yes. Any paper form can be replicated or choose one of our free templates and add your logo.

How are forms transmitted?

You choose! Plain text, 2-column HTML, Excel (CSV), XML or PDF formats

Why use Secure Forms?
Safeguard your business and your customers - forms are HIPAA compliant, encrypted and transmitted over a secure network. Pricing is per organization and if you purchase a batch of forms, those forms will be designed and branded for only (1) organization.  The Pro version can have up to (2) unique organizations.  A unique organization is defined as being any entity with it's own name or branding.

Send Us An Email
DO NOT add any patient health information here. We will follow up with you to discuss any PHI or security credentials. DO NOT share any PHI or any credentials in this help desk ticket. Thank you!

Send Us An Email

Get in Touch

  Mediprocity Inc.
714 Spirit 40 Park Drive
Chesterfield, MO 63005