How it works

You send a form. We take it from there.

The form we build is the real one for your practice, not a sample or a mock-up. You try it before you decide, and when you go live, it's the same form your patients fill in.

Four steps, and most of the work is ours.

Send us your form. We'll turn it into an online form your patients can complete and your staff can put to work.

  1. You

    Send us your form

    About two minutes

    Upload a blank PDF, Word document or photo of your paper form. Tell us whether you'd rather have a call or an email, and we'll take it from there.

    Your first form, up to two pages, is free. We include every question from your form, exactly as written.

    Have a whole packet? Start with one form, and we'll plan the rest together.

    Please upload a blank form with no patient information.

  2. Us

    We confirm the details

    A short call or a few emails

    We'll ask how your office uses the form, where completed forms should go, and who needs to see them.

    Want help improving the wording, the questions or the order? We can talk about that too.

  3. Us

    We build it. You try it.

    Built for phones, tablets and computers

    We send you your working form. Fill it in as a patient would, submit a test, and see exactly what your office receives.

    Tell us what you'd change, and we'll make the adjustments included with your build.

  4. You

    Go live when you're ready

    Choose your plan

    Ready to use it with patients? Choose a service plan and sign a Business Associate Agreement with us. We finish the setup and send you its live link. It's the same form you tried, now ready for real patients.

    Put the link on your website, in appointment reminders or on a tablet at the front desk.

Get your first form free

Keep it, or make it better

Your form as it is.
Or refined together.

Already have the form you need? Our Form Conversion turns it into an online form, keeping your wording and questions intact.

Want help improving it? With Form Review & Build, we review it with you to make it easier for patients to complete and more useful to your team.

  • Ask only what you need

    We help identify outdated or unnecessary questions, so patients spend less time filling out forms and your staff have less to review.

  • Add what helps your team

    Include questions your clinicians routinely ask, so they have more of the information they need before the visit.

  • Make answers easier to get right

    Clear instructions and fields suited to each question help patients enter dates, insurance details and other information with fewer mistakes.

  • Preserve what matters

    We work with you to keep the required wording, consents, acknowledgements and signatures your office relies on.

Compare build options

Watch it happen

From your paper form to their phone to your office.

See how a patient completes your online form, and what your team receives with Workflow Portal. The practice and patient are made up, and there's no sound: the captions tell the story.
Read what the video shows
  1. From your paper form to their phone to your office.
  2. A paper new-patient form from Cove & Pine Family Dentistry, a made-up practice. Send us the form you use today, on paper or as a PDF.
  3. The same form opens on a phone as a secure online form, in the practice's colors.
  4. A patient fills it in one step at a time, adds a photo of an insurance card, taps yes or no, signs with a finger and sends it securely to the office.
  5. The office gets an email that a form is ready to review, with no patient details in it.
  6. In the portal, Submissions lists every form, newest first.
  7. Opening the form marks it In progress, with who opened it and when.
  8. Clicking an answer copies it, ready to paste into your practice software; "Copy this part" copies a whole section.
  9. A question about the patient's medicines is flagged and goes on the Follow-up list.
  10. The completed, signed PDF downloads from the form, and every download is recorded.
  11. The office ticks its own step, Insurance checked, then marks the form processed.
  12. A quick tour of the rest. Set your own steps, switch forms on and off, print a QR sign for the front desk, invite your team, see who opened and downloaded what, and sign in with Face ID.
  13. Get your first form free at secure-form.com.

Rather try it yourself? Try the demo form

After you go live

  • Completed forms, organized in your portal

    View, search, download and track submissions in your secure portal. You can also receive completed forms by secure email.

    Prefer email only, without long-term storage on our servers? We keep submissions for just 30 days to help ensure successful email delivery, then delete them.

    See the Workflow Portal

  • Need a change? Just ask.

    Small updates are included, such as adjusting wording, adding a few questions or removing fields. For new forms, major revisions or substantial additions, we'll give you a quote before work begins.

    See what's included

  • Support from people who know your forms

    When you need help, you can reach the team that builds and maintains your forms. We'll help keep them working for your office as your needs change.

Your first form is on us.

Send us a blank form of up to two pages. We'll build it as you send it, as a working online form, free. Try it from start to finish, with no commitment.

Get your first form free

Live patient use requires an annual service plan and a signed Business Associate Agreement.