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How it Works
Form Builder
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Form Builder

LuxSci SecureForm FormBuilder

Easy Web Form Creation & Secure Hosting

Visual. Flexible. HIPAA-compliant.
Ideal for:
- Creating Forms: No Coding
- Secure Form Hosting
- HIPAA Consent and Release Forms
- Contact, Customer Request, Survey & Legal Forms
- WordPress Friendly
- Responsive Mobile Forms
- Collecting Digital Signatures

HIPAA-compliant Form Builder

Most medical and health-based organizations require HIPAA-compliant forms to keep track of and transfer sensitive patient information. LuxSci's SecureForm Form Builder is a developmental tool that helps you organize, manage, and store all those forms in one place. The SecureForm FormBuilder provides easy Web form creation and secure hosting that's completely HIPAA- (Health Insurance Portability and Accountability) compliant. You can ensure the protection of your data during transmission because our hosted forms use encrypted text are accessible over TLS. FormBuilder also allows you to include custom CSS and Java Script to adjust the complexity of your security levels as needed.

Our form building and hosting services are ideal for contact, customer request, survey, and legal forms. Our forms are also responsive to mobile devices and designed to seamlessly collect digital signatures. You can start from scratch or with one of our templates as a guiding tool to create your form(s). All of our forms are also WordPress-friendly and easy to update. Use LuxSci's SecureForm FormBuilder as a simple way to organize and automate your business. SecureForm FormBuilder provides the online security necessary for a safe and efficient practice.

Perhaps you were wondering...?

Is FormBuilder easy?
Yes. FormBuilder is a WYSIWYG (what you see is what you get) editor with a tool bar that makes it simple for anyone to create basic or stunning Web forms. FormBuilder also includes templates you can use to get you going.
Is the form hosted securely?
Yes. FormBuilder hosted forms are accessible over TLS, only.
How flexible is FormBuilder?
Very. FormBuilder includes jQuery and allows you to include arbitrary JavaScript and CSS, permitting you to create very complex forms: for instance dynamic forms, use of third-party form widgets, custom validation, etc. FormBuilder even permits you to view and edit the HTML source code for your form.
Can I embed my form in my existing website?
Yes. You can embed your FormBuilder form in any existing website using an iframe.
Can I upload/include images in my forms?
Yes. You can either
  1. Upload to FormBuilder for secure hosting and inclusion in your form, or
  2. Link to images you have hosted elsewhere
What are some of the things that I can't do with FormBuilder?
At least without a lot of complex JavaScript work, you cannot:
  • Password-protect forms
  • Have multi-page forms that save the data of all pages and submit it as a single unit at the end, or that allow you to save and resume your work.
Is SecureForm hosting redundant and scalable?
Yes. Amazon AWS Cloud hosts FormBuilder forms. They can scale to vast numbers of concurrent viewers and are safe from underlying server issues affecting uptime or performance.
Can I transfer my existing forms to FormBuilder for hosting?
You can copy and paste existing form content into FormBuilder, import existing images, and include your own JavaScript and CSS. However, FormBuilder is not a classical Web hosting space, so you can't upload an existing website or a directory of existing files.
How does FormBuilder work with SecureForm?
FormBuilder is built into SecureForm, so the forms you design in FormBuilder are automatically configured to send data to SecureForm. You do not have to do anything in FormBuilder itself to connect it properly to SecureForm.
Is it possible to have FormBuilder forms send data to a system other than SecureForm?
Other questions? Call Sales

FormBuilder Feature List

Building Forms


Visual HTML+Form Editor: No HTML Skills Needed

Add Ink Signatures

Form Builder includes a tool where you can insert and customize one or more Ink Signature boxes in your forms.

File Upload Input Fields?

Form builder allows you to add "File Upload" input fields to your form so that end users can submit files as well as other information.

Images Upload and Hosting

You can upload images for display in your web site form. These will also be securely hosted with your form.

Paste in an Existing Form?

If you have an existing form, you can copy and paste it into the Form Builder. The existing styles and look will be preserved as best as possible (all styles become inline styles on the elements).

Form Field Validation: Required Fields

Form Field Validation: Field Format

Form Builder can check text fields for valid:

  • Email address
  • Phone numbers
  • US Zip/Postal Codes
  • Credit Card Numbers
  • Web Site URLs
  • IP Addresses (v4)
  • US Social Security Numbers
  • Set a maximum length on the number of characters entered.

AJAX Submission detects offline state

SecureForm FormBuilder submits your forms* using AJAX. If the form submission fails due to lack of connectivity (e.g. the user or offline or the server is down/inaccessible), then the end user is notified with a little pop-up and can re-try the submission. The filled-in form is not lost.

* Does not apply to forms with file upload fields, as file upload is not currently supported over AJAX.

Got it all figured out?

Monthly accounts start at $25

No need to migrate your website or anything to LuxSci.

New accounts ready in 1 hour*
Start designing your forms in minutes
Free 30-minute training call included

Welcome to LuxSci!

...any questions?

* for orders placed between 9am and 10pm Eastern Time, USA. Provisioning can be delayed due to issues validating orders.

I just wanted to say thanks to all the great support and salespeople I've dealt with from LuxSci. Our website launched this weekend nearly flawlessly and had great help from your support department. Keep up the good work!"
Bryan Patrick
Website Administrator, CentrePointe Counseling, Inc.
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Starting at 25/mo
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"Thank you for your willingness to accommodate my client's specific needs. I appreciate the considerable effort you put into adding a feature to SecureForm that supports PDFs created with Adobe Acrobat Professional. I think it's a valuable enhancement to an already great service, and I genuinely appreciate your hard work. Thanks again to the LuxSci team for being so responsive!"

—Rainer Freytag, Webmaster & Digital Artist,

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• Access Anywhere
• Fast and Robust
• Super Secure
• Tons of Features
• Customizable
• Mobile Friendly

Send and receive email from your favorite programs, including:

 Microsoft Outlook
 Mozilla Thunderbird
 Apple Mail
 Windows Mail

... Virtually any program that supports POP, IMAP, or SMTP

Keep your email, contacts, and calendars in sync:

 Apple iPhone and iPad
 Android Devices
 Windows Phone

... Any device with Exchange ActiveSync (EAS) support

Relay your server's mail through LuxSci via smarthost:

• Resolve issues with ISP sending limits and restrictions
• Improve deliverability with better IP reputation and IP masking
• Take advantage of Email Archival and HIPAA Compliance
• Even setup smarthosting from Google Apps!

Free web site hosting with any email account:

• Start with up to 10 web sites and MySQL databases
• DNS services for one domain included
• Tons of features and fully HIPAA capable

LuxSci's focus on security and privacy:

• Read The Case for Email Security
• Read Mitigating Security & Privacy Threats
• Review our Privacy Policy

The most accurate, flexible, and trusted filters in the business:

• Premium protection with Intel Security Saas
• Realtime virus database guards against the latest threats
• Seven-day quarantine lets you put eyes on every filtered email
• Supplement with our Basic Spam Filter for even more features

End-to-end secure email encryption — to anyone, from anyone:

• No setup required — encryption is automatic and easy to use
• Secure outbound email with TLS, PGP, S/MIME, or Escrow
• Free inbound encryption via our SecureSend portal
• Independent of your recipient's level of email security
• Widely compatible and fully HIPAA Compliant

Add an extra layer of security with an SSL Certificate:

• Secure your web site
• Debrand LuxSci WebMail with your own secure domain
• Access secure email services via your own secure domain

Encrypt your service traffic via secure tunnel:

• Add another layer of security to your SSL connections
• WebMail, POP, IMAP, SMTP, web/database access
• SecureForm posts, SecureLine Escrow, SecureSend access
• Restrict your account to VPN access only

Secure long-term message archival:

• Immutable, tamperproof email retention with audit trails
• No system requirements — minimal setup, even less upkeep
• Realtime archival of all inbound and outbound messages
• Works anywhere — even with non-LuxSci email hosting

Free data backups included with all email hosting accounts:

• Automatic backups of all email, WebAides, web/database data
• Seven daily backups and up to four weekly backups
• Unlimited restores included at no additional cost
• Custom backup schedules for dedicated servers

Automate your email management:

• Save messages to specific folders or to LuxSci WebAides
• Advanced text scanning with regular expressions
• Tag messages, alter subject lines, or add custom headers
• Filter by message charset, type, TLS status, DKIM status
• Chain filters together for even more complex actions

• Bulk add and edit users, aliases and more
• Control sharing and access globally or on a granular level
• Delegate user roles through permissions
• Configure account-wide taglines, sending restrictions, and more
• Remotely administer account via SOAP API

Share, collaborate, organize, synchronize:

• Calendars, Contacts, Documents, Notes, Widgets, Workspaces
• Fine-grained access control and security
• Access anywhere via secure web portal or smartphone
• Save over solutions like Microsoft Exchange

Free folder sharing for all email hosting accounts:

• Share mail folders with other users in your account
• Subscribe to only the folders you want to see
• Set read-only or read-write access control
• View all personal and shared folders via unified web interface

Color code and label your email messages:

• Define and assign multiple IMAP keywords to each message
• Filter, search, and sort by tags
• Compatible and synchronizes with any IMAP email client
• Also usable with WebAide entries