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Video Transcript

Secure Form is a service that provides a secure and HIPAA compliant solution for hosting and processing online web forms. Let's take a look at this intake form. Each form you create is assigned it's own URL, which can be opened as a link from your website or iframe within a page on your website. The FormBuilder tab provides a WYSIWYG editor for building your forms. On the toolbar, many options for creating your form including adding form fields, editing, formatting, adding images, you can also add date pickers, file upload buttons, there's a ink signature for signed forms.

As you build a form, the FormBuilder creates the HTML code for you in the background and you can toggle between the form view and the HTML source code view with this button. You don't need to know HTML to make the forms but if you do, you also have the flexibility of going in and editing the code directly. This can either be done directly in the editor or by copying the code into a different editor and copying it back. It's also possible to add Java Script as well as CSS styling.

On the settings tab is an option to add a link to an external CSS page or you can edit the raw CSS directly in here. On the settings tab, you can also select to have a responsive version of the form and format that version for the narrower screens of mobile devices. Once a form is submitted, the daily can be sent in a number of ways such as, you can have it sent to you via email, posted to an FTP site, posted to an online folder such as Web Aids Tab or to a database.

The most common way to get the form submission data is by email. Getting it by email, we use TLS encryption and it's HIPAA compliant. One of the great features of Secure Form is that you can receive the data in a number of formats. For instance, you can get it into column HTML, plain text, CSV which we open up in Excel, XML and you can choose more than one format or any combination of these that you like.

One other option is to have the data refilled into a PDF template. This option becomes available after uploading the PDF template on this tab. Let me conclude this demo by showing you how you would fill out a form and receive the data back as a PDF template. On this form tab, if you hover over the preview button and click it, it'll open up the form I and a web browser where we can fill it out. As we continue to fill out this form, and lastly sign it, which you can do with your mouse, stylus, your finger, you're going to also on form, add a clear signature button and we'll click submit.

On the success page, you can add a link to download a copy of the form. This would be done to provide a copy to your patients of the form that they just filled out. You don't have to do it but it's an option. Here's the email we received with the form submission data refilled into a PDF. Let's take a look and see what this looks like. Here's the PDF of the form, signature and all. With Secure Form, you can host your forms online, being HIPAA compliant. Thanks for watching.

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LuxSci offers a very comprehensive secure hosting solution for healthcare organizations who must navigate complex HIPAA regulations and safeguard their patients' data. Not only is the site well secured and monitored constantly—the site loads quickly, operates reliably, and we have been thrilled with the immediate response from support staff when the occasional question comes up or we are in need of more advanced support on the development side. I highly recommend LuxSci's products and services."

Nathan Schmidt . Summit Home Medical Equipment