Stop Printing.
Start Signing.
CareCertify builds HIPAA-secure electronic forms for Minnesota 245D home care agencies — clients and employees sign right on their phone, tablet, or computer. No scanning. No filing. No lost paperwork.
Paper forms are costing your agency time and money
Lost and incomplete paperwork
Paper forms get lost, misfiled, or returned incomplete. During a DHS inspection, missing documentation puts your license at risk.
Hours wasted on printing and scanning
Your staff spends hours printing, collecting, scanning, and filing forms that should take minutes. That time could go toward client care.
HIPAA risks with paper records
Unsecured paper files, faxes, and email attachments expose your agency to HIPAA violations. Electronic forms with encryption eliminate that risk.
Every form your 245D agency needs
All forms are built to 245D documentation standards, HIPAA-encrypted, and configured to automatically email completed copies to your agency and the signer.
Client Intake & Enrollment
Comprehensive intake capturing demographics, diagnoses, waiver type, emergency contacts, and service preferences.
Service Agreement / Contract
245D-compliant service agreement covering scope of services, rates, responsibilities, and required disclosures — with e-signature.
Informed Consent
HIPAA-compliant consent for services, data sharing, photography, and emergency medical treatment — with guardian signature support.
Incident Report
245D-required incident documentation capturing event details, witnesses, actions taken, and follow-up — triggers supervisor notification email.
Employee Application
Full employment application including work history, references, availability, and required 245D background study authorization consent.
Background Study Authorization
DHS-required background study consent form for all employees and volunteers, with electronic signature and date-stamp documentation.
Medication Administration Record
Digital MAR capturing medication name, dose, route, time, and DSP initials — with missed dose and refusal documentation fields.
Custom Form Builds
Need a form that isn’t in our catalog? We build custom HIPAA-secure JotForm forms to your exact specifications — any 245D documentation requirement.
Up and running in days, not weeks
We build your forms
We configure your agency’s forms in JotForm HIPAA Gold — branded with your logo, mapped to 245D fields, and set up with e-signature and auto-notifications.
We set up your account
Your agency gets its own JotForm workspace with HIPAA encryption enabled. Your BAA is in place before any data touches the system.
Share with clients & staff
Send a link by text or email. Clients and employees sign on their phone, tablet, or computer — no app needed, no printing required.
Completed forms auto-file
Submissions are encrypted and stored in JotForm. Your agency receives an automatic email copy. Pull any record instantly during a DHS inspection.
See exactly what your clients and staff will experience
These are real HIPAA-secure forms — the same ones we build for agencies. Fill one out right here to see how the experience works on any device.
These are live demo forms for preview purposes. Submissions during demo are not stored as PHI. Your agency’s forms will be customized with your branding and fields.
Simple, transparent form access
Forms are included with your CareCertify training subscription or available as standalone packages. Custom builds are quoted per project.
Forms Access
- Access to all 6 standard forms
- HIPAA-encrypted submissions
- E-signature on all forms
- Auto-email copies to agency
- Unlimited submissions
- Custom form builds
- Agency branding / logo
Training + Forms Bundle
- All 6 standard forms included
- HIPAA-encrypted submissions
- E-signature on all forms
- Auto-email copies to agency
- Unlimited submissions
- Agency branding / logo on forms
- Custom form builds
Custom Form Build
- Any field type or logic
- Conditional branching
- Multi-signer workflows
- Auto-routing to supervisors
- Agency branding
- Integration with your EHR / EVV
MAR (Medication Administration Record) forms are available as a custom build add-on. Contact us for pricing →
Ready to go paperless?
Let us build your agency’s HIPAA-secure form set. Most agencies are up and running within 3 business days.