Give patients an easier way to fill out your forms.
Improve patient experiences by letting people fill out familiar web forms using the device in their pocket. We fill out PDFs and send copies to you. No more fumbling with clipboards!
Accessible by Design
Technology is an equalizer that eliminates struggles with pen & paper. Many people have problems with writing because of limited dexterity, limited vision, or other health conditions.
HIPAA-Compliant
Patient forms collect lots of electronic protected health information (ePHI). We adhere to strict HIPAA and HITECH compliance standards to keep ePHI safe & secure.
Environmentally-Friendly
Healthcare uses a lot of paper. Paper comes from trees. Trees make forests. Eliminate paper, save some trees, and help to preserve access to the outdoors for physical & mental health.
Solves a Real Problem
Our founder has quadriplegia from an alpine skiing accident, resulting in no fine motor control in his hands. AlpineForm was created to eliminate the need for assistance with paper forms.
Why AlpineForm?
1. To be more accommodating.
Keyboards, touch, & voice input help people who struggle with handwriting, vision, & more.
2. To be more efficient.
Patients can fill out paperwork in advance. Save digital copies without any scanning.
3. To be more profitable.
Time is money. Reduce time in the waiting room. Reduce admin time. See more patients.
Your patients are already on their phones.
We create & maintain HIPAA-compliant web versions of your paper forms so patients can complete paperwork on a modern device.
We take the data, fill out a PDF, and email it to you. The best part? We use your existing forms, so learning a new system is unnecessary.
Web forms are more convenient.
Nearly everyone has a smartphone with them all the time. If given the choice to fill out a paper or an online form in person, patients will most likely choose the web-based version.
Patients can also complete paperwork in advance and avoid the 10-15 minute wait before their appointments.
Web forms are more accessible.
Our forms are usable on any device with a modern web browser. They work well on any size screen, and comply with Section 508 and WCAG 2.1 AA standards.
All you need to share is a link. This can be done over email, text, or with a QR Code on display in your office.
Paperwork gets sent via email.
Our forms “magically” fill out your existing forms and immediately send a PDF copy to your office’s email address, ready for your staff to add to your patient files.
Your brand comes first.
Branding leads to trust. Each form will have your practice’s logo or name (not ours!) on top. We’ll also create a index page that lists your forms & contact info.
Fully HIPAA-compliant.
Keeping ePHI safe & secure is a top-level priority. We adhere to strict HIPAA compliance standards for our business and technical infrastructure.
Headache-free.
AlpineForm is designed to fit into your existing processes. Your forms won’t change. You’ll just receive them electronically.
If your staff already uses HIPAA-compliant email and some form of digital file storage, this will be easy for them to adapt to.
Pricing:
Give us a Try, no obligation…
FREE
for 4 weeks.
Curious if web-based forms could be useful for your practice? Try us for 4 weeks. No commitment. No payment required.
This is a done-for-you service, not do-it-yourself software, so it will take a little bit of time for us to get new accounts up and running. You’ll have 4 weeks free once your forms are ready to go.
If at the end of 4 weeks you like what we offer, we’ll set up billing. If we’re not a good fit, we’ll part ways with no hard feelings.
Free trials are limited to one form. This is because of the time involved to (1) create a web form that collects data to match the paper form, (2) program the web form to fill out PDFs, (3) build a web page for the form, (4) set up email notifications, and more.
HIPAA-compliant, BAA included
Unlimited submissions
Then, If we’re a good fit…
$169
/month billed annually, or $199 billed monthly.
Each form has a $149 one-time conversion fee.
HIPAA-compliant with 45 CFR Part 164 Subpart C
Business Associate Agreement (BAA)
Unlimited web forms
Unlimited submissions
Branded index page for all of your forms
Printable PDF with QR code to direct patients to your forms
Easy linking to your forms from your website
Private forms for staff use
Secure & redundant data archiving
Spam suppression for each form
Human support by email, phone, or text
Guarantee:
Over the next 30 days after your free trial, if AlpineForm isn’t working out, let us know! We’ll refund 100% of your money, even after completing the work. Your forms must receive multiple patient submissions to qualify.
Billing:
ACH bank transfers, major credit & debit cards are accepted, securely processed by Stripe. A 3.5% surcharge will be added for card processing. Billing is automated and hands-off once it’s set up.
Questions?
AlpineForm is small, bootstrapped, and owner-operated. Get in touch with me directly. No AI. No hassle.
Scott Pruett, founder
scott@alpineform.com
(540) 358-0137