Surgical Store Intake Form - Dome Technology Solutions, LLC
This electronic form is designed so that a tablet or smartphone can replace the forms that are used to collect customer contact information, personal insurance information, and all of the details of the items provided with the proper codes.
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It creates a PDF that can be stored for records as well as downloading the data on to a spreadsheet. It can be used as a template to customize a dynamic form for a healthcare provider. Note; Whenever health Information is collected proper security measures must be taken. With proper procedures this electronic form can collect and store all of your data in compliance with HIPAA regulations. For more information on customization and complying with privacy regulations contact us at firstname.lastname@example.org.
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