Healthcare Intake
Patient intake, HIPAA, and consent PDFs in one API call.
Patients fill one digital intake on your portal. SimplyFill produces the HIPAA acknowledgement, registration, insurance verification, and consent PDFs as a single signed-ready envelope.
Intake paperwork is the worst part of every first visit.
Patients fill the same fields on six different clipboards. Front desk re-types it into the EHR. Half the consent forms come back missing a signature, and the HIPAA acknowledgement is two weeks old. Every minute of intake friction is a minute of clinical time lost.
- Patients re-enter the same demographic data on 4–6 separate forms.
- Consent forms expire, and stale templates ship out without anyone noticing.
- Insurance verification is filled by hand from a phone-call transcript.
- Multi-state practices need different consent variants per location.
One portal intake fans out into every required PDF.
Wire your patient portal to SimplyFill. When intake submits, we generate the full chart-ready envelope — HIPAA acknowledgement, registration, insurance verification, financial responsibility, treatment consent — using your branded letterhead.
- Bundle the entire intake packet in a single bulk request — typical latency under 2 seconds.
- State-specific consent variants resolve from a single mapping based on the practice location.
- Output flattens cleanly so it imports into Epic, Cerner, eClinicalWorks, athena, and DrChrono document modules.
- Patient data is processed in memory and discarded after the PDF is produced — generated files are encrypted at rest.
- BAA available so your practice can stay covered under HIPAA on day one.
Why teams pick SimplyFill
Front-desk-free intake
Patients submit once and walk in with a complete chart. Front desk reviews, never re-types.
HIPAA-aware infrastructure
Encrypted at rest, encrypted in transit, BAA on request. Patient data is not retained in request payloads.
EHR-ready outputs
Generated PDFs slot into Epic, Cerner, eClinicalWorks, athena, and DrChrono document stores without manual labeling.
See it in code
Generate the full new-patient envelope from one portal submission
curl -X POST https://api.simplyfill.app/v1/generate/bulk \
-H "Authorization: Bearer $SIMPLYFILL_API_KEY" \
-H "Content-Type: application/json" \
-d '{
"documents": [
{ "template_id": "hipaa_ack_v2025", "mapping_id": "intake_default" },
{ "template_id": "patient_registration_v3","mapping_id": "intake_default" },
{ "template_id": "insurance_verification", "mapping_id": "intake_default" },
{ "template_id": "consent_treatment_ca", "mapping_id": "intake_default" }
],
"data": {
"patient_legal_name": "Erick Ramirez",
"date_of_birth": "1990-04-12",
"preferred_pronouns": "he/him",
"street_address": "1 Market St",
"city": "San Francisco",
"state": "CA",
"zip": "94105",
"insurer_name": "Blue Shield",
"insurer_member_id": "BS-***-1234",
"emergency_contact_name": "Jamie Chen",
"emergency_contact_phone": "415-555-0148"
},
"envelope": true
}'Frequently asked questions
Do you sign a BAA?
Yes — every paid plan includes a Business Associate Agreement so your practice stays covered under HIPAA. Email security@simplyfill.app to request the current BAA terms and Subprocessor list.
Where is patient data stored?
Request payloads are processed in memory and discarded after the PDF is produced; SimplyFill is stateless on the request body. Generated PDFs are encrypted at rest in your region of choice. See /security for the full data-handling write-up.
Can I use this with Epic, Cerner, or eClinicalWorks?
Yes. Any EHR with an HL7, FHIR, or REST API can drive SimplyFill — pull the patient record, post it to our generate endpoint, and push the resulting PDFs back into the EHR document store.
What about state-specific consent forms?
Upload each state variant as a template and key your mapping off the practice location. The same bulk request resolves the right template per patient — California consent for the SF office, Texas consent for the Austin office.
Are generated PDFs encrypted at rest?
Yes — AES-256 at rest, TLS 1.3 in transit. Download URLs are short-lived and tied to your account so a leaked link cannot be replayed.
How do you handle minor patients and guardianship signatures?
The intake template captures guardian fields and conditionally renders the guardian signature block when the patient is under 18. The HIPAA acknowledgement and treatment consent both inherit the same conditional logic.
Ship healthcare intake PDFs without the busywork.
Free tier ships with 100 PDFs/month, no credit card required. Upgrade only when you go to production.