Faster, More Accurate Hospital/Clinic Patient Intake Forms

Safeguarding Protected Health Information


Whenever new patients use the services of a hospital or physician practice, they must complete forms that list their contact information, medical history, insurance information, and acknowledgement of various HIPAA regulations. These handwritten forms must then be manually entered into a computer by clerical staff which is time consuming and error prone leading to billing errors, higher operational costs, and lower patient satisfaction.

Any solution to replace this process must:

  • encrypt data when transferred over the Internet (as regulated by HIPAA)
  • be very easy for end users
  • not require special software or hardware
  • provide easy portability into back end systems


DataMotion SecureForms provides an interactive PDF form that can be emailed to any new patient prior to their appointment with the doctor. The form is completed online at the patient’s convenience, and then automatically submitted back to the physician’s office. The data is automatically encrypted when transmitted over the Internet, and can be delivered as a separate entry for each patient, or automatically ported into the providers back end system or database.

Benefits and Results

Using this solution patient data is automatically entered into the system, eliminating the costs to read and enter the data by clerical staff. Patients are empowered to help in their intake process, errors are greatly reduced, and staff are freed up for more important tasks.

Patient intake is only one of many processes that every office performs. Other paper forms can also be replaced by DataMotion SecureForms with the same level of accuracy and cost savings.

Contact us to find out if SecureForms is the right solution for your patient intake application.

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