Online Patient Registration

Save time - HIPAA-compliant registration of patients online instead of on-site

No more paper forms: accept secure data online and in time

No more paper storage: it's all in the cloud

Get up and running quickly; no training or setup required

Forms go straight to your secure storage space for easy access

ShieldQ for Healthcare secure webforms transform the patient registration process


With ShieldQ’s secure webform and signature service, clinics can now save valuable time by asking first-time patients to fill out all necessary forms online, at their convenience.

No more delayed appointments, no more daily schedule disruptions when patients try to fill out the forms onsite, while waiting to see their doctor.






  • Easy to use form builder: Create forms using multiple field options 
  • Forms published in minutes: Host on your site or on a dedicated page
  • ShieldQ custom forms: Let us design forms for you, to meet your needs
  • Links to forms: Simply send patients a link to the form(s) prior to their appointment
  • All-in-one forms make registration a breeze: Let patients complete the process in one go: fill in details, add files (medical records, health insurance approvals), sign and submit.
  • Secure, HIPAA-compliant storage: Submitted forms go straight into ShieldQ's HIPAA-compliant repository and can be conveniently accessed by clinic staff at any time 

No more paper forms: accept webforms directly into ShieldQ

Keep to schedule by managing data online

No more searching for physical documents: gain instant access

Receive data from multiple channels: faxes, emails, forms, uploads

ShieldQ by InterFAX is HIPAA compliant, and was the first Internet faxing company to be accredited as a Level 1 PCI DSS-compliant service provider. The company is dedicated to ensuring that its highly secure online services meet the world's most stringent privacy and security regulations, both today, and tomorrow.

Contact one of our representatives today and get set up in minutes!