Secure Forms

NeoCertified’s Secure Web Form is fully customizable and will give your website users a simple way to send sensitive information securely. If you don’t have your own website, don’t worry! We can host your very own page with your Secure Form for you. $195 for a limited time!

Secure Contact Form

Security Your Way

Secure Forms

Start Connecting Securely With Your Website Visitors & Clients!

NeoCertified’s Secure Forms are available for businesses of all sizes and can be placed on your webpage in just a matter of seconds. If you don’t have your own website, don’t worry! NeoCertified can host your very own page with your Secure Form for you. Any and all data submitted across NeoCertified’s Secure Forms are encrypted at all times and are HIPAA-compliant with current laws & regulations.

Secure Forms Continued…

We Offer A Plethora Of Options!

Our Secure Forms can be built from scratch by the NeoCertified team based on your provided requirements or can come pre-loaded from NeoCertified’s ‘Standard’ Secure Form option. Each Secure Form can be customized in a number of ways: add an unlimited number of fields, customize field labels, enable field requirement options, and place “File Upload” fields for your clients.

HIPAA Compliant Email

Customize Your Security

Learn More About Our Secure Forms Encryption Solution

Sending and receiving secure emails is now easier than ever before with our Secure Forms Solution. Below you will find more information about NeoCertified’s Secure Web Form.

Customizable Fields
  • NeoCertified can customize the entire Secure Form based on the fields & requirements you provide, or you can request NeoCertified’s Standard Option (see example above), to create the Secure Form perfect for your business (additional fees apply). Place the form on your website, or in your signature block.
Compliance Requirements
  • Our Secure Forms are compliant with federal regulations, such as HIPAA / FINRA / FERPA / SOX / GLBA / and SEC. Ensure that your clients are able to communicate securely with your business by giving them the power to compose their own secure messages with our Secure Forms.
Secure File Upload
  • Allow website visitors to upload files and documents up to 200 MB in size securely to your organization in a matter of seconds. From patient files and health records to tax documents and payment info, your clients now have the ability to upload files securely to your business with no hassle.
NeoCertified Licenses
  • We offer a 30-day money-back guarantee on all purchased NeoCertified licenses.
  • For NeoCertified clients that purchase 10 or more licenses, CustomerConnect (our secure contact form widget) can be included with your purchase at no additional charge.
  • Discounts are available for Non-profit organizations and for large quantity license purchases.
Secure Form


All of our agreements are one-year, with a 30-day money-back guarantee!