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PerfectPC Services, LLC
PO Box 1045
Muncie, IN 47308
1-800-775-3928
Fax
1-888-479-8522
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By Email:  Click Here

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PerfectPC Services will help your business create a form for  your website to collect data entered online securely, then give you secure access to retrieve the form in PDF format that can then be saved or printed out.

An example of use would be Muncie Allergy Center.  They have several Intake forms that patients fill out when they come in for the first time.  PerfectPC Services was able to take the exact forms used in the office and make online fillable forms at their website.  Once the customer had filled out the forms, Muncie Allergy Center was sent a notification of the new forms through email.  They log into a secure area and choose that client's form and open it.  From that point they can print it out or save it to the customers electronic file.

Here is a graphical look at the process:


Below is a live sample of how the process works. 

 The form below is encrypted to comply with HIPPA regulations.


1. Client Login Area

On each clients website will be a link for admin access to form data.

2. After login, client can see all submissions.

Each web submission can then be viewed, printed, or downloaded.

Cost to have this technology:

1. $50 setup fee per form.
2. $5 per month to have secure account login.

To signup for this technology on your own, Click here.
 

Do you already have an account with us? Click Here to login.
 

 
 
 

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