For multi-location specialty practices
Replace paper patient intake.
HIPAA-compliant. 2 to 4 weeks..
Paper packets at the front desk are a HIPAA risk, a staffing tax, and a conversion killer at the moment a patient is most ready to commit. We migrate practices to a JotForm HIPAA-compliant digital workflow with a Cloudflare Email Worker relay.
If you're living this
The symptoms are consistent.
Paper intake is the friction point that compounds. It bleeds HIPAA-compliance posture, staff time, and patient experience at the same moment they decided to choose your practice.
- Paper packets handed to patients in the lobby, then re-keyed by staff into the EMR
- Email-based intake forms running through staff inboxes with no audit trail
- A vendor form that says "HIPAA-compliant" but no signed BAA
- Sensitive fields (SSN, DOB, insurance) collected over channels that cannot be audited
- Front-desk turnover bleeding intake quality across locations
- A Security Risk Assessment that covered the EMR but never the intake stack
What's included
Five components. One handoff.
Fixed scope. We migrate, train, monitor, and walk away with you owning the platform. You can extend the engagement after if you want ongoing intake-form work, but the migration itself terminates clean.
Component 01
Foundation: BAA + tenant setup
JotForm HIPAA tier provisioned + signed BAA on file. Tenant configured under your ownership, not ours. You walk away owning the platform.
Component 02
Form architecture
Intake forms designed around your specialty + provider list + service areas. Conditional logic, clean field validation, mobile-first. Patients can complete the workflow on a phone in the parking lot.
Component 03
Submission relay
Cloudflare Email Worker filters and relays clean submissions to the right inbox at the right location. No raw PHI in plaintext email. Audit trail of every submission.
Component 04
EMR handshake (optional)
For practices on ECW, athenahealth, Modernizing Medicine, or NextGen, we can wire submissions to the EMR via the supported API where the practice has integration access. Scoped separately.
Component 05
Staff training + handoff
Front-desk training session + written runbook + 30-day post-launch monitoring. Then we hand it off and you run it.
Pattern from the field
Dental specialty practice.
Closed deliverable, anonymized for client privacy. The migration shipped well inside the published timeline window, then expanded into a multi-year retainer.
- Multi-location dental specialty practice
- Paper packets pre-engagement; HIPAA workflow live well inside the published timeline window
- Front-desk re-keying time eliminated
- Cloudflare Email Worker filtering + clean inbox routing
- Engagement extended into Authority-Weighted SEO + Site Refresh after intake landed clean
What you get
Five deliverables. $8,000 to $18,000 fixed.
Priced off your specialty, location count, and patient-volume band. 50% on signature, 50% at handoff. EMR integration scoped separately if needed.
- JotForm HIPAA tier with signed BAA under your ownership
- Patient intake form set tailored to your specialty and provider list
- Cloudflare Email Worker relay with audit logging
- Staff training session + intake runbook
- 30-day post-launch monitoring + bug-fix window
Who this is for
If you fit, the call is worth your time.
- Specialty practices on ECW, athenahealth, Modernizing Medicine, NextGen, or running paper-only
- Multi-location or single-location, 1 to 20 locations
- Patient volume that makes paper intake a real friction (typically 20+ new patients/week per location)
- BAA hygiene is a real concern (recent audit, OCR letter, board review, MSP transition)
Next step
Tell us about your intake stack.
Fill in the form. We'll review and reach out within one business day to schedule a 30-minute scoping call.
30-minute discovery call
Want the long version?
Let's talk.
Fill in the form below for the full Overlay one-pager. We'll review your situation, fit-check on the call, and walk away if it's wrong. No pitch theater.
Fill in the form below for the full Overlay one-pager. We'll review your situation, fit-check on the call, and walk away if it's wrong. No pitch theater.