Secure Form

Make a Free Custom Secure Form for Any Website

Create a one-of-a-kind Secure Form in minutes
with no design experience or coding needed.

Start for free

No credit card required

4.6

(5,164)

4.5

(17,321)

4.6

(343)

4.4

(130)

4.8

(238)

What POWR Secure Form does to help you

Patient Intake 3x Faster

Creating quality HIPAA forms saves you time collecting patient information and responding to inquiries and messages.

Boost Survey Results up to 300%

With well-designed, multi-step surveys with conditional logic that are easier for people to finish than their morning coffee.

Stay HIPAA Compliant

Avoid hefty fines and time-consuming audits with a fully compliant online HIPAA form.

"POWR has enhanced my website and makes my life easier in the process, which let's face it, is what we all need more of in our lives!”

Lisa Hardy

@ Good World Graphics

24/7

Support

7M+

Global customers

50K

Five star reviews

1000+

Platforms

Secure Form customization in minutes, not hours

HIPAA Compliance

Data Encryption
All data collected through the form is encrypted during transmission and stored.
Access Controls
Only authorized personnel can access the data.
Audit Logs
Records are maintained of who accesses the data and when.
Secure Dashboard
Form responses dashboard is encrypted, secure, and only accessible by the account administrator.

Advanced Customization

Rich Form Elements
Choose dropdowns, multiple-choice, star ratings, file uploads, emoji feedback, picture choice, and more.
Multi-Page Forms
Great for surveys or long forms to make them more user-friendly.
Post-Submission Options
Redirect to a thank you page, show a custom message, or hide the form.
Conditional Logic
Show or hide specific questions based on someone’s previous response.

Notifications

Email Notifications‎
Set up email notifications for new form submissions.
Instant Submission Alerts
Get an instant notification anytime someone completes one of your HIPAA forms.
Autoresponder Emails
Set up secure conditional autoresponder emails for your customers that send after they submit your HIPAA form.

12+ million websites improved (and counting)

Very responsive customer support. Richcarde M. walked me through step by step on a new method for page updates. Saved me hours of tinkering.

Map

Good Filling

Working great for years and the tech support is great!

Form Builder

OMNI12

Brilliant support from your team. Very happy with the product and your quick support.

Popup

Bex's Coffee

Every plugin has a similar look and feel, so the learning curve for our staff is minimal as new ones are introduced.

AskDr.Ganz.com

Awesome, quick, and easy! Thank you for making my site look legit!

Instagram Feed

Woodies Drumsticks

Outstanding customer service I love the app easy to work with . But I love the fact I can get an actual human to help me.

Email Signup

JetLife Travel

Absolutely loved the experience with the POWR! Our first time using it, we reached out through their live chat feature, and they responded in just a minute.

Comments

Black Forest

Just installed the app. Looks great and works perfectly

Customer Survey

La Mome Bijou

Looks great and works perfectly.

Registration Form

Nurture Your Pet

Got all the help I needed to showcase my work with PowerPoint image slider.

Image Slider

OnlyFridays