Fees and scope
50% on signature; 50% at handoff. Includes agreed forms, locations, routing, training, runbook and 30-day monitoring/bug fixes. EMR integration is quoted separately.
Patient intake for specialty practices
Replace paper intake.
Train your front desk.
$8,000–$18,000 fixed base
Discuss your intake workflowPlanned 2–4 weeks after access, requirements and required agreements. EMR integration is separate.
CLIENT-OWNED FORM
A simple starting point.
Practice locationExample North
Administrative visit typeFirst visit
Patient content stays in the approved system.
STAFF NOTIFICATION
New submission available.
Sign in to the approved system to review.
No patient content in the notification.
Exact services, access, agreements and BAA coverage must be confirmed before real data handling.
BEFORE THE SWITCH
Synthetic routing tests + staff training + approved cutover and rollback.
AFTER LAUNCH
Practice keeps the tenant and runbook. Included monitoring and bug fixes: 30 days from launch.
Included in your scope
What you receive.
Illustrative document previews · contents agreed in your scope
- Client-owned tenant + access
- Forms + documented routing
- Synthetic tests + staff training
- Runbook + 30-day monitoring
Boundaries
You own the JotForm account. Confirm the applicable HIPAA plan, covered services and agreements. Patient content stays in approved systems, never notifications. This service does not certify compliance.
Inputs and handoff checks
What your team brings
Specialty, providers, service areas, forms, current workflow, practice approver and vendor contacts. Identify BAA, sensitive-field and access concerns; arrange access through the approved process.
Acceptance and handoff
Agree cutover and rollback, run authorized synthetic routing/mobile checks, train staff and obtain practice approval. Agree existing-record handling and retention before retiring the old workflow.
We check EMR access, permissions, feasibility and data handling before quoting. Write-back is separate and not guaranteed. Vendor delays or scope changes affect timing. You keep the account and documentation; support after 30 days and a retainer are optional.
Before we begin
Questions about the scope.
What's included in the base $8,000 to $18,000 fee?
A client-owned JotForm tenant on the applicable HIPAA plan, access settings, the agreed intake forms, documented routing, staff training, a written runbook and 30 days of monitoring and bug fixes from launch. Required agreements and service coverage are confirmed before patient information is handled. Patient content stays in the approved system and is excluded from notifications. EMR integration is quoted separately. This is implementation support, not a compliance certification.
How long does an intake migration take?
The planned base implementation is 2 to 4 weeks after vendor access, the form requirements and required agreements are in place. It covers form setup, authorized synthetic testing, staff training and handoff. EMR integration, vendor delays or changes in scope can extend the schedule. The 30-day monitoring window begins at launch.
Which EMRs does the intake form connect to?
Integration depends on the EMR vendor's supported APIs, your access permissions and the agreed data flow. We review feasibility before quoting a build. The base scope covers forms and submission routing; EMR write-back is a separate scope and is not guaranteed.
What happens after the 30-day monitoring window?
The tenant and implementation documentation remain with your practice. Ongoing form support or other work can be quoted under a separate scope. An ongoing retainer is optional.
How is the transition tested?
We agree the cutover and rollback plan with your team, test the routing with synthetic data, and train staff before launch. Your team approves the switch. The handling and retention of existing records are agreed before any old workflow is retired.
Start with a business conversation
Discuss your intake workflow.
Leave your contact details, company name and timeline. We will follow up about your forms, routing and vendor requirements before proposing work.
Business inquiries only. No patient information, medical records, passwords or credentials. Sensitive workflow access needs a separate agreement.