HIPAA Forms

Collect PHI without touching it

Embed a one-line React component. Patients fill the form inside our secure iframe. PHI never reaches your servers — ever.

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One component. Zero PHI exposure.

The entire patient form runs in an isolated iframe hosted by HaaS. Your app only ever sees a token.

intake.tsx

import { HaaSForm } from '@haas/react'

// Drop this anywhere in your app
<HaaSForm
  formId="patient-intake"
  onSuccess={(token) => saveToDb(token)}
/>

● PHI stays in HaaS iframeYour server receives token only

End-to-End Encrypted

Patient data encrypted in-browser before any network transmission. AES-256-GCM. Your server never sees plaintext PHI.

Fully White-Labeled

Custom logo, colors, fonts, domain. Patients see your brand. HaaS is invisible. Enterprise: custom CSS overrides.

Mobile-First

Responsive, accessible, touch-optimized. Works on every device. WCAG 2.1 AA compliant out of the box.

Multi-Language

Support patients in their native language. 40+ locales supported. RTL languages included.

< 200ms Load Time

Forms load in under 200ms. Globally distributed CDN. Critical path optimized. No layout shift.

Accessibility First

Screen reader optimized. Keyboard navigation. Color contrast compliant. ARIA labels on every field.

Built for every patient interaction

Patient Intake

Medical history

Current medications

Allergies & conditions

Insurance information

Emergency contacts

Consent Forms

HIPAA authorization

Treatment consent

Research participation

Photo/video release

Telehealth consent

Health Assessments

PHQ-9 depression screening

GAD-7 anxiety scale

Health risk assessments

Post-visit surveys

Medication adherence

Start collecting PHI today

Free sandbox. Build your first form in 10 minutes.

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