Are you still using paper forms in your practice?

Client intake forms, satisfaction surveys, and other forms are critical to your work. But they’re not much fun to fill out, and they often come back illegible or incomplete.

Hush™ Secure Forms is our secure alternative to old-fashioned paper forms. Launch a beautiful, personalized web form for your business with our drag-and-drop form builder, ready-made templates, built-in secure web hosting and electronic signatures.

Drag-and-drop form builder

It has never been quicker to create your own customized secure web form. Simply drag fields to your form, name your fields, and click Publish when you’re done. It's that easy. You won't need to hire an expensive web developer or learn to write code.

Ready-made templates

Need some help getting started? We have a collection of templates you can use as a starting point for your form. It’s a great way to find inspiration, or to find a completed template that already works for your business.

Built-in secure web hosting

When you publish your new form, we’ll host it for you on our secure, mobile-friendly website. Link to your secure web form from your website or send it by email. Clients can complete your form at their leisure, on their preferred device. See a sample form.

Delivered to your Inbox

When your client completes your form, it’s delivered instantly to your secure Inbox along with an attached PDF you can upload to an EHR. Because you’re using Hushmail, you can continue the conversation by sending an encrypted reply.

Supports your HIPAA compliance

We protect your web forms using the same encryption as your Hushmail email account. If you're on a Hushmail for Healthcare plan, this helps to support your HIPAA compliance.

Conditional visibility

You can set conditions to determine when a field will be visible on your form. Setting conditions makes your form responsive to your clients, giving them a more personalized experience.

Body charts

Add a body chart to your form and invite patients to indicate points of pain or discomfort that they can describe in associated fields. This pinpointing ability is especially useful for healthcare practitioners such as chiropractors, physical therapists, and massage therapists.

Embed your form on your website

You can put your complete form on your website and invite your clients to fill it out there. By copying and pasting a line of HTML code, you can place a form anywhere you choose and retain Hushmail’s effortless style.

Self-administered questionnaires

We offer self-administered questionnaires in our template directory. These digital versions of popular mental health screenings deliver a score upon completion to the practitioner. PHQ-9, GAD-7, DASS, PTSD Checklist for DSM-5 (PCL-5), AUDIT, and more.

Have us build your forms

Don't have time to build your own forms? Have us do it for you. Most Hushmail for Healthcare plans come with at least one hour ($50) of bonus form building credit.

We have a plan that's just right for your business

Hushmail for Healthcare includes Encrypted Email, Secure Web Forms, a Private Message Center, and optionally Electronic Signatures. We'll include a signed Business Associate Agreement (BAA) and Email Archiving to help with your HIPAA compliance.

Overview

Starter

$
9.99
per month

Recommended

$
19.99
per month

Custom

Please contact us for custom pricing

Encrypted email accounts 1 Up to 5 Up to
Secure web forms Up to 2 Up to 5 Up to
Electronic signatures Not included Included Included
Private message center Included Included Included
Business Associate Agreement HIPAA Included Included Included
60-day money back guarantee Included Included Included
Form building credit Bonus $50 $100 $100 $200
Encrypted Email
Webmail (desktop & mobile) Included Included Included
Works with email apps (e.g. Outlook) Included Included Included
Hushmail for iPhone Included Included Included
Custom domain (@yourcompany.com) Included Included Included
Send & receive encrypted file attachments Included Included Included
Email aliases Unlimited Unlimited Unlimited
Storage (per email account) 10 GB 15 GB 15 GB
Secure Web Forms
Monthly form submissions Unlimited Unlimited Unlimited
Maximum pages per form Unlimited Unlimited Unlimited
Ready-made form templates Included Included Included
Calculated questionnaires (e.g. PHQ-9) Included Included Included
Design your own forms Included Included Included
Receive form submissions as PDFs Included Included Included
Conditional field visibility Included Included Included
Share forms with colleagues Not included Included Included
Body charts Not included Included Included
Electronic Signatures
Sign on desktop and mobile Not included Included Included
Detailed activity records Not included Included Included
ESIGN and UETA compliant Not included Included Included
One signer per form Not included Included Included
Multiple signers per form Not included Not included Coming soon
Private Message Center
Maximum clients per month Unlimited Unlimited Unlimited
Clients can send secure replies Included Included Included
Automatically expiring messages (2 weeks) Included Included Included
Customization & Branding
Custom logo Not included Included Included
Custom secure web form accent color Not included Included Included
Remove Powered by logo from forms Not included Not included Included
Customer Care
One-on-one setup assistance by phone Included Included Included
Technical support by phone and email Included Included Included
Online knowledge base Included Included Included
Security & Compliance
Business Associate Agreement HIPAA Included Included Included
Email archiving HIPAA Included Included Included
Information Manager Agreement (Canada) Included Included Included
Two-step verification Included Included Included
Encryption OpenPGP & SSL OpenPGP & SSL OpenPGP & SSL
Domain Administration (if using a custom domain)
Standard email forwarding Included Included Included
Catch-all email forwarding Included Included Included
Manage user accounts Not included Included Included

All prices displayed are in US dollars. Taxes may apply. Full refund if you cancel within 60 days.

Hushmail for Small Business includes Encrypted Email, Secure Web Forms, a Private Message Center, and optionally Email Archiving and Electronic Signatures.

All prices displayed are in US dollars. Taxes may apply.

Hushmail for Law includes Encrypted Email, Secure Web Forms, a Private Message Center, and Email Archiving, and optionally Electronic Signatures. Plus, we'll sign an agreement with customers in the U.S., Canada and the U.K. to seek judicial protection for the account, if necessary, on the basis that the contents are privileged, providing extra protection for your communications.

All prices displayed are in US dollars. Taxes may apply.

Hushmail for Personal Use includes Encrypted Email, Secure Web Forms, and a Private Message Center, with an email address ending in , , , or . Custom email domains are not available on this plan.

All prices displayed are in US dollars. Taxes may apply.

From the Blog

What happens when a HIPAA complaint is filed against you

Published on June 17, 2021

We’re taking a look at HIPAA violations: how they occur, how they are reported, what happens during and after an investigation, and what you can do to prevent a complaint from being filed in the first place. Read more.