Practis Forms - Secure Patient Forms

Version 2.0

On-line patient forms provide an easy, affordable and secure way for medical practices to communicate with patients while protecting health information as required by HIPAA.

Standard Forms Available

Prescription Renewal Referral Request
Patient Registration
Appointment Request
PT/OT Renewal
Workers Comp
Vanderbilt Forms

Online Bill Pay
Image/Film Request - Radiology
P/E Request Form - Peds
Contact Your Provider
Patient Assessment
Referring Consult Form

Secure On-line Bill Pay

Allow patients to pay their account balance conveniently and securely through your own website. We have three different options available to support your needs. Learn more >

Secure On-line Vanderbilt Assessment Forms - NEW!

Pediatric groups - allow parents and teachers to complete ADHD Assessment forms securely online, eliminating the need to fax or mail them back. Learn more >

Secure On-line Exam Requisition Form

Radiology groups - allow your referring physicians to securely log-in and request an exam through your website.. We have a standard online request form that can be customized to your requirements. Contact us at 800-238-0095 to inquire.

Form Benefits

Security

HIPAA rules advise that the electronic transfer of and access to protected health information be addressed through the use of encryption and authentication.

Improved Workflow

Automated, customized message routing directs each type of form results message to the most appropriate staff member that you determine. Completion of secure online form eases the workflow issues in your office.

Specifically:

Patients and request and office staff can efficiently process patient appointment, prescription renewal, referral requests at a time that is convenient for them.
Online pre-registration allows you to check eligibility of insurance information prior to patient visits.
Online forms save patient and office staff time.
Securely ask questions of billing staff and nursing staff.
Opportunity to capture email addresses for practice announcements or communication.

Structured Content

Using our forms ensures that you collect the information that you need, in the format that you require. This helps to reduce call backs and make your practice operate more efficiently when processing patient requests.

Practis Inc.

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