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WebGirly3
05-08-2012, 04:57 AM
I asked this on an Adobe Acrobat forum but haven't gotten anywhere so I thought I'd try here.. I hope someone can help.

My customer is a doctor's office and they would like their patients to submit their paperwork online. The problem is, the office does not want to receive unformatted form data results. They want to receive the PDF exactly as it looks when someone would fill it out in the office so they can print it and keep a uniform look for all of their patient files.

Here's one of the forms:
http://dryoungs.com/docs/New_Patient_Form_Print.pdf

You can currently fill it out and then print it but they want to submit it online through a secure server. We can't allow customers to email the form because of HIPPA laws and privacy issues. I don't have experience in doing anything more than what I've already done with this form which was to add the form fields and print button.

I received a quote for $2,500 from this doctor's current hosting company to get this form and one other working through their secure server. This seems outrageously high especially since I've already added the fields to the form but I really don't have anything to compare it to so maybe it's not.?

As you can see, I'm at a loss.. Any help or suggestions would be greatly appreciated. Or even if there is someone we can hire, I'm sure the customer would be fine with doing that.

Thanks in advance!
Tara

edbr
05-08-2012, 05:37 AM
so you need an upload script? does the server support php?

WebGirly3
05-08-2012, 05:45 AM
When you say upload script, do you mean the patient would save the file on their computer and then upload it to them through the website?

If so, that is not what we need. We need a Submit button at the bottom of the PDF that will send it in the complete PDF format over to the office securely, not by emailing it.

But, yes the server has PHP5 installed. Thanks for your reply.

edbr
05-08-2012, 05:49 AM
so can you clear this. the form is downloaded to be filled in?

edbr
05-08-2012, 05:51 AM
you still will need an upload script to upload the file.

WebGirly3
05-08-2012, 05:55 AM
You don't actually download and save the form. When the patient comes to the website, they click the link and the PDF opens like this: http://dryoungs.com/docs/New_Patient_Form_Print.pdf.

Currently, they can fill out the PDF, print it and bring it into the office instead of writing in the information by hand. A lot of times, patients forget to bring the paperwork with them so the doctor wants the patients to go to the site, fill out the PDF and send it to the office through the web server.

To ask the patient to download the form, fill it out, save it to their computer and then go back to the website and upload it when they are done is too much. We want to avoid that if at all possible.

WebGirly3
05-08-2012, 05:57 AM
Basically at the bottom of the PDF form, they want a 'Submit' button that sends the form through the server. No saving of the documents to their computer or upload scripts to send it back. We want it all done within the PDF form itself.

edbr
05-08-2012, 05:59 AM
yes but submit must have an upload handler , thats what upload means. pdf does not have the ability to upload to anywhere

is this any use to you?
http://luxsci.com/blog/auto-upload-web-and-pdf-form-post-data-to-your-ftpsftp-site-with-secureform.html

WebGirly3
05-08-2012, 06:14 AM
Yes, this may work. Thank you for the direction. Obviously, I don't know enough about this so I apologize for my lack of knowledge on how it works. Thanks again

edbr
05-08-2012, 06:25 AM
no problem at all