How long does it take to get a form live?
Most forms are ready within a day or two of our first conversation. Long forms, or ones with a lot of branching, take a little longer.
FAQ
Straight answers.
The questions offices ask before they start, answered the way we'd answer them on the phone.
Getting started
What kinds of forms can you build?
Any form your office asks patients or families to fill in. New-patient intake, medical and dental history, consents and acknowledgements, admissions paperwork, pre-visit questionnaires. If it's on paper or in a PDF today, we can build it.
Do we need to install anything?
No. Each form is a link. Put it on your website, in an appointment reminder, or open it on a tablet at the front desk. It works on phones, tablets and computers.
Who builds the form?
We do. You send us a blank copy, we check in with a few questions, and we build it, as it is or improved with you. You try it as a patient would before it goes live.
What if we have a lot of forms?
Start with one. Your first form, up to two pages, is free, and while we build it we can scope the rest of your forms together and give you a fixed quote.
The free first form
What does the free first form include?
One form of up to two pages, built exactly as you send it, working from start to finish. You fill it in as a patient would, submit it, and see what your office receives. It costs nothing and there's no commitment.
What's the catch?
There isn't one. The build is free, and it stays free: if you continue with us, that form carries no setup fee. To use it with real patients you choose a service plan, and we sign a Business Associate Agreement and our Services Agreement. If you don't, nothing happens.
Can the free form take real patient information?
Once it's on a service plan, with a Business Associate Agreement and our Services Agreement signed, yes. Until then, try it with made-up details.
Will you use our information for marketing?
No. We will never sell your information or add you to a marketing list. We reach out, by email or phone, your choice, to help you get your form built, and that's all.
Your patients' data
Is it HIPAA compliant?
We sign a Business Associate Agreement with every client before live patient information is processed. With Direct Delivery, a completed form is processed, delivered to your office by encrypted email, and kept in our application for 30 days, then deleted. With Workflow Portal, completed forms stay in your portal, kept apart from every other practice's and encrypted with a key used only for your practice. For HIPAA covered entities and business associates, each Workflow Portal submission is also kept in a backup archive locked against deletion. The Security page spells out how.
Do you sign a BAA?
Yes, with every client, before a form takes real patient information, along with our Services Agreement. Fieldstone Health's Security & Privacy page explains how our agreements protect you and links our sample BAA, so you can read it before you sign anything.
How do completed forms get into our system, such as Dentrix?
We don't connect directly to Dentrix, Epic or other record systems. With Direct Delivery, each completed form reaches your office as a PDF by encrypted email, which you file the same way you would a scanned form. With Workflow Portal, you open each submission in your portal, copy any answer with one click to paste it into your system, and download the PDF to file.
How long do you keep completed forms?
With Direct Delivery, 30 days after the PDF is delivered to you, long enough to send it again if an email goes astray, so your patient never fills the form in twice. Then it's deleted, and backup copies expire within a further 30 days. With Workflow Portal, in your portal for as long as you're a client, unless you ask us to set a shorter period. Your staff can't delete submissions; we delete junk or duplicates when you ask, and whenever the law requires. For HIPAA covered entities and business associates, each Workflow Portal submission is also kept in a backup archive for one year, locked so that neither a mistake nor an intruder can erase it. Direct Delivery submissions are never archived.
What happens to our data if we leave?
It's yours. With Direct Delivery, any submission we still hold is returned securely if you ask, up to 30 days after the end. With Workflow Portal, you get one free export if you ask, up to 10 days after the end. Then we delete all submissions, forms and account data within 30 days, and backup copies expire within a further 30. Copies in the Workflow Portal locked archive can't be deleted early, even by us, so each one is deleted when its one-year lock ends, and stays protected as patient information until then.
Pricing
How much does it cost?
Two parts. A one-time build fee per form, for up to three pages $195 for Form Conversion or $395 for Form Review & Build, with a fixed quote before we start. And an annual service plan, Workflow Portal at $1,990 a year with portal setup and staff training included, or Direct Delivery at $890 a year. Your first form is free.
What's the difference between Form Conversion and Form Review & Build?
Form Conversion builds your form with your existing wording and questions, with one round of revisions. Form Review & Build starts with a review session on your questions and office workflow, then recommends wording, fields, question order and conditional questions where helpful, with two rounds of revisions.
What's the difference between Workflow Portal and Direct Delivery?
What happens to a completed form. With Direct Delivery it arrives by secure email as a PDF. With Workflow Portal it lands in your portal, where you can search, download and track it with a status. The Pricing page compares them line by line.
What do changes cost after launch?
Small changes are part of the service: adjusting wording, adding a few questions, or removing fields. New forms, major revisions, and substantial additions are quoted before work begins.
Can you build a Spanish version?
Yes. Spanish is added to the same form as a language toggle, for $25 per page with a $75 minimum. You supply your approved Spanish wording, or we arrange professional medical translation at an additional cost, confirmed before work begins.
Working together
Who will we actually work with?
People who know healthcare forms and will get to know your office and yours. You'll reach the same people each time, before launch and after.
What if we call and nobody picks up?
Leave a message, or email us, and we'll get back to you. We reply by email unless you ask for a call.
Can we talk to a person before sending anything?
Of course. Email or call us, or send a note through the contact page, and we'll reach out the way you prefer.
Still have a question?
Email, call, or send a short message, and we'll get back to you.
Your first form is on us.
Send us a form of up to two pages. We build it free, you try it from start to finish, and there's no commitment.
When you're ready to use it with real patients, choose a service plan and sign a Business Associate Agreement with us.