6 Replies Latest reply on May 8, 2012 1:35 AM by Dave Merchant

    New Patient Forms online


      We currently have a  PDF of our new patient forms on our website for patients to print off, fill out, and bring to their appointment with them.  We've had way too many patients go through that process but then forget to bring the paperwork with them.  I'd like a way for them to fill it out on-line and then submit it to us, and we'll print it and have it ready for them on their first visit.  I don't even care about capturing or using any of the data on the forms, just being able to print it.

      Can someone let me know the best way to do that?

      Thanks so much!!!

        • 1. Re: New Patient Forms online
          gkaiseril MVP & Adobe Community Professional

          Yes, it might be possible. You will have to comply with the HIPAA act. We would not want the patient's famiy to know about the patient's health.


          I would look at setting up an secured web site or page to gather this data.


          You definatly should not use email.

          • 2. Re: New Patient Forms online
            Bill@VT Level 7

            Agreed. Also, with the numbers you will be dealing with the file should not be Activated for Reader or you will likely violate the license within a month. That means that they would submit the data to you in FDF form (from AcroForms) or XML form if Designer is used. You simply open the file in Acrobat and import the data file into the form (depending on the setup, you may be able to double click on the data file and have it open up in the form -- but that might be something to be explored later and may only work with FDF data).

            • 3. Re: New Patient Forms online
              Dave Merchant MVP & Adobe Community Professional

              Rick should also consider using Adobe FormsCentral, as there are no such limitations on the receipt volumes (plus it works on mobile devices). If a PDF form isn't Reader-extended then novice users will be confused by the "you cannot save data" warning messages that Reader will display.

              • 4. Re: New Patient Forms online

                I have a similar issue. My customer is a doctor's office and they would like their patients to submit their paperwork online. The problem is the office does not want to receive unformatted form data results. They want to receive the PDF exactly as it looks when someone would fill it out in the office so they can print it and keep a uniform look for all of their patient files. (I don't know if 'RickAInAZ' was asking for the same thing)


                Here's one of the forms:



                You can currently fill it out and then print it but they want to submit it online. As mentioned above, we can't email it because of HIPPA and privacy issues. I don't have experience in doing anything more than what I've already done with this form. Does it take alot of expertise in Acrobat to do this? Can it be done with Adobe FormsCentral? If not, where could I find someone that I can hire to help me with this? I receive a quote for $2,500 from this doctor's current hosting company to get 2 forms working through their secure server. This seems outrageously high but I really don't have anything to compare it to so maybe it's not.


                As you can see, I'm at a loss.. Any help (as descriptive as possible) would be greatly appreciated.


                Thanks in advance!


                • 5. Re: New Patient Forms online
                  Phillip M Jones Level 4

                  When I was Treasurer and Web Designer for an Electronics Association I created Pdf then sent to the person in Charge of the Convention

                  Then I sent  had the same form on my computer I filled in the form and had it emailed to the fdf information to PDF on the other end. But it has been so many years ago I can't rememberthe exact steps. IF we could go back in time about 10-15 years ago the steps used might still even be in The Acrobat Forum archives.

                  • 6. Re: New Patient Forms online
                    Dave Merchant MVP & Adobe Community Professional

                    @WebGirly3: See my tutorial on server-side data collection here: http://tv.adobe.com/watch/acrobat-community-tv/working-with-form-data/


                    The typical workflow to process PDF > XFDF > PDF on a server (to avoid external mail transfer and the 500-recipient limit) does involve writing code in PHP or ASP to parse the inbound data, but it's an easy job for a web programmer:


                    - PDF files is constructed to submit data to a web URL (typically https for your type of data)

                    - A script on the server parses the form data and warns the user via a return message if anything's missing or wrong (see my video tutorial)

                    - The script optionally writes the form fields to a database.

                    - The script then constructs a 'flat' version of the PDF (without interactive form fields) using a server CGI library such as pdflib or FPDF

                    - The recipient either logs in to download it, or the PDF is sent via email (secured with PGP or with the PDF encrypted)



                    Adobe Acrobat is only involved in the first step, after that you're using server-side programming tools.