No, we don’t do long-term contracts.
WordPress HIPAA Compliance
$4999 + $199/month
Website Risk Analysis
Website Risk Management
Data backup plan
Disaster recovery plan
Emergency mode operation plan
Testing and revision procedures
Application and data criticality analysis
Access establishment and modification
Protection from malicious software
Response and reporting
Annual Technical Evaluation
HIPAA compliance for:
45 CFR 164.308(a)(1)(ii)(A)-(B)
45 CFR 164.308(a)(5)(ii)(A)-(C)
45 CFR 164.308(a)(7)(ii)(A)-(E)
AlpineForm Patient Forms
6 electronic form conversions*
Unlimited form submissions
Unlimited form updates
Private forms for staff use
PDF + CSV of each form submission
Live data access via Google Sheets*
Branded electronic form URLs
Public page for easy access to forms
Custom domain for public page*
Short URLs for sharing forms via text
QR code for sharing forms in-office
Invisible reCaptcha spam suppression
Secure data archiving
Fully HIPAA-compliant with:
25% off WordPress HIPAA Compliance
The AlpineForm Sign-Up Process:
- Sign our Business Associate Agreement.
- Submit payment.
- Set up an account on AlpineForm.com.
- Upload copies of your paper forms.
- We’ll get to work!
* Billing Info:
- AlpineForm only: We bill the first 3 months upfront to cover the initial setup and form conversion costs. Monthly billing will start after 90 days.
- Billing is automated via MoonClerk and securely processed by Stripe. Major credit/debit cards or ACH bank transfers are accepted.
- Please contact us to request annual billing.
* AlpineForm Info:
- AlpineForm plans include up to 6 forms that we convert to an electronic version and program to fill out a PDF and send you a CSV that matches your existing paper forms. Additional forms require a one-time conversion fee and will not increase the monthly rate.
- Live data access with AlpineForm is achieved through Google Sheets. All form data is saved in a spreadsheet unique to each form and will be accessible only to you at any time. To receive access, you must have a Google Workspace account and proof of a signed Business Associate Agreement with Google for HIPAA compliance.
- Custom domains will make your public page accessible through an URL other than alpineform.com, like forms.yourbusiness.com, which can increase trust for some people. If you choose to use a custom domain/subdomain, you’ll need the ability to update your domain’s DNS to add a CNAME record that points to alpineform.com.
WordPress HIPAA Compliance Waitlist:
- Our WordPress HIPAA Compliance enrollment is on hold as we focus on AlpineForm. If interested in this service, please fill out the form below. We’ll reach out when we can give you the time & attention you deserve.
- Joining our waitlist does not imply a commitment. We’ll simply let you know when we open enrollment back up.