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Client wants regular email or text? Document the request

Get a secure Request for Alternative Communication form, often called a "HIPAA waiver," for clients who ask to receive low-risk messages, such as scheduling or billing, via regular email or text.

Sign up for Hushmail and get a ready-to-use Request for Alternative Communication form.

  • Helps clients make an informed choice

  • Supports a clear HIPAA-compliant workflow

  • Delivers completed forms securely to your inbox

Request for Alternative Communication Form
47,000+ healthcare professionals use Hushmail to communicate with clients and coordinate care securely

Help clients make informed communication choices

Some clients prefer regular email or text for low-risk messages, such as scheduling, appointment reminders, and basic billing questions.

A Request for Alternative Communication helps you explain the risks in plain language, so clients can decide how they want those messages handled.

It also gives you a clear record of their choice.

Your clients can complete your Request for Alternative Communiaton

What is a Request for Alternative Communication?

Many healthcare providers refer to it as a "HIPAA waiver." It's the form that documents the client's preference for certain low-risk messages, such as scheduling or billing questions, to be delivered via a less secure channel.

It helps clients understand the risks of regular email and text so they can make an informed decision.

The request:

  • Documents the client's request to use a less secure communication method
  • Applies to certain low-risk messages
  • Shows the request was informed and voluntary
  • Allows clients to change their preference
e-signable

Why use a secure online form?

A client's request is PHI, even if they're only asking to use regular email or text for simple messages. That's why it's important to send, collect, and store the request securely.

With Hushmail, clients can review the request, acknowledge the risks, and sign online. When they're done, the completed form arrives securely in your inbox.

No printing. No scanning. No chasing paperwork.

  • Clients can complete the form online

  • Completed forms arrive securely in your inbox

  • Sent and stored with a service that includes a signed BAA

How it works

link-to-contact-form
1. Send the request form

Send the form to clients who ask to receive certain low-risk messages by regular email or text.

e-sign
2. Client reviews and signs

The client reviews the communication options, acknowledges the risks of regular email and text, and signs the form.

receive-submissions
3. Receive the completed form

When the client submits the form, it arrives in your Hushmail inbox for your records.

conversation
4. Communicate accordingly

Use regular email or text only for the types of messages identified in the form, and use secure messaging for all other sensitive information.

“Much more readable than Adobe”

Opening Quote Mark

We were pleasantly surprised with the user-friendly Hushmail forms, backed up by excellent customer support … They are quite professional in appearance, much more readable than Adobe, and a cinch to edit. They seem also to encourage our patients to … provide more robust and usable information … And the added bonus of scorable clinical questionnaires is icing on the Hushmail cake.

Howard Bierenbaum
Howard Bierenbaum
PhD, President, Newport News, VA

Manage secure messages and forms in one place

Client communication rarely ends with a single form.

With Hushmail, you can document communication preferences, collect signed forms online, and send secure messages when privacy matters.

Use Hushmail for key client touchpoints, including:

  • Request for Alternative Communication forms

  • Intake forms

  • Consent forms

  • Appointment request forms

  • Insurance update forms

  • Self-administered health questionnaires (PHQ-9,
    GAD-7, PCL 5, DASS, SCARED, AUDIT, & more)

Intake paperwork
Have a question?

Get support from a team that knows the ins and outs of healthcare

Hushmail isn't a faceless software product. For the past 25 years, we've helped countless healthcare practices streamline their practice and support their HIPAA compliance.

If you need help getting started, creating web forms, or have questions about HIPAA compliance, our team is on hand to help.

Don't have time to create web forms?

When you sign up for Hushmail, you can choose to have our team convert your existing paperwork into secure web forms for you for a small additional fee.

Rated 5 out of 5 stars Invited Invited
Dr. Eric C. Olson

Fantastic Customer Service, Experts in HIPAA Compliance for Healthcare Providers

I chose Hushmail for its informative website on HIPAA policies for healthcare providers, and the initial discovery call with Mahsa who thoroughly answered my questions and explained their services. It was an easy process to get started, and the customer service team has been very helpful! I am glad that I chose Hushmail to help me secure protected health information in my new practice. A bonus service they offer is a form building tool that I can use for my website or to directly e-mail patients intake paperwork. Thank you Hushmail for being an important part of my team!

Document client email and text requests with confidence

Start a 14-day free trial and use a Request for Alternative Communication form designed for healthcare providers.

Sign up for Hushmail
FAQ

If you still have questions, you're not alone. We're here to help.