HIPAA Compliant Web Forms
HIPAA Compliant Web Forms is a WordPress plugin, operated by Code Monkeys LLC, that lets U.S. healthcare providers and web developers build HIPAA-compliant online intake, consent, and contact forms, with a freemium subscription model starting at $65 per month.
- Company typePrivate
- Founded2018
- HeadquartersHammond, United States
- Headcount—
- GTM typeB2B
- OfferingSoftware
What HIPAA Compliant Web Forms does
HIPAA Compliant Web Forms, operated by Code Monkeys LLC, provides a WordPress plugin that enables healthcare organizations to collect patient information online in a HIPAA-compliant manner. Founded in 2018 by Ed Paulsen and based in Hammond, Wisconsin, the product integrates with the two leading WordPress form builders — Caldera Forms and Gravity Forms — so that web developers and healthcare operators can assemble patient intake, contact, and consent forms without building custom compliance infrastructure themselves. The company supports secure form submission, file uploads, and Business Associate Agreement-backed handling of protected health information (PHI), positioning itself as a regulatory-fit alternative to general-purpose form plugins for U.S. healthcare use cases.
The business model is a tiered, freemium subscription aimed at small and mid-sized healthcare providers, the web designers and developers who build sites for them, and insurance agencies. A free tier offers one form and 25 submissions per month; the Standard tier is priced at $65/month, $190/quarter, or $715/year; the Plus File Upload tier is $95/month, $270/quarter, or $1,015/year; and a $100 one-time setup service is offered. There is no disclosed external funding, no published headcount, and a single named customer testimonial (Medical Advertising Professionals / VPINTEA), indicating a small, founder-operated operation.
In June 2026 the company is preparing to release Akashic Health Records, an adjacent electronic health records product that would extend the offering beyond form collection into broader clinical record keeping, while the core plugin continues to receive iterative updates (version 3.3.0). All publicly visible activity is U.S.-focused, and there are no signals of geographic expansion or external investment to date.
HIPAA Compliant Web Forms firmographics
Firmographics- Name
- HIPAA Compliant Web Forms
- Legal name
- Code Monkeys LLC
- Website
- https://hipaaforms.online
- Company type
- Private
- Founded year
- 2018
- Operating status
- Operating
- Short description
- HIPAA Compliant Web Forms is a WordPress plugin, operated by Code Monkeys LLC, that lets U.S. healthcare providers and web developers build HIPAA-compliant online intake, consent, and contact forms, with a freemium subscription model starting at $65 per month.
- Ownership category
- akta.pro rank
HIPAA Compliant Web Forms industry classification
Industry- Product category
- HIPAA Compliance Software
- NAICS
- Software Publishers (5132)
- SIC
- Services-Prepackaged Software (7372)
- akta.pro primary industry
- Patient Access, Registration & Intake (Front-End RCM) (HLACACAE)
Keywords
Where HIPAA Compliant Web Forms is headquartered
LocationHeadquarters
- HQ city
- Hammond
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
HIPAA Compliant Web Forms business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Technology or R&D, Personnel, Infrastructure, Marketing or Sales, Operations
Revenue model
- Basic Free Tier: Free subscription tier offering 1 active form and 25 submissions/month. Generates revenue through conversion to paid Standard plans. No credit card required.
- Standard Subscription Plans: Paid subscription tiers providing unlimited forms and submissions. Available in monthly ($65), quarterly ($190), and annual ($715) billing cycles. Includes 1 live domain and 1 staging domain.
- Plus File Upload Subscription: Standard subscription with unlimited file upload capability. Available in monthly ($95), quarterly ($270), and annual ($1,015) billing cycles.
- Setup Service: One-time $100 fee for plugin installation, configuration, and creation of one HIPAA-compliant form. Professional services for customers who need hands-on assistance.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Freemium | Annual | Basic Free - 1 form, 25 submissions/month |
| Subscription | Monthly | Standard Monthly - Unlimited forms and submissions |
| Subscription | Multi-year contract | Standard Quarterly - Unlimited forms and submissions |
| Subscription | Annual | Standard Annual - Unlimited forms and submissions |
| Subscription | Monthly | Plus File Upload Monthly - Standard plus unlimited file uploads |
| Subscription | Multi-year contract | Plus File Upload Quarterly - Standard plus unlimited file uploads |
| Subscription | Annual | Plus File Upload Annual - Standard plus unlimited file uploads |
| One time/ perpetual license | Pay-as-you-go | Setup Service - One-time professional installation and configuration |
Go-to-market motion2 records
Distribution channels2 records
Marketing channels3 records
HIPAA Compliant Web Forms product offering
Product offeringCore offering
Code Monkeys LLC sells HIPAA Forms, a WordPress plugin plus API service that converts forms built with Caldera Forms or Gravity Forms into HIPAA-compliant forms by encrypting submissions and storing E-PHI on HIPAA-compliant infrastructure separate from the customer's hosting server. The product includes drag-and-draw digital signatures, secure password-protected PDF generation, role-based form separation by clinic or doctor, audit-grade access logging, and a Business Associate Agreement (BAA). Subscriptions are offered as a free Basic tier (1 form, 25 submissions/month) and Standard or Plus paid tiers (monthly, quarterly, or annual), with an optional $100 one-time Setup Service for installation and configuration.
Product overview
HIPAA Compliant Web Forms offers a WordPress plugin and API service that enables healthcare organizations to securely collect and store patient information through HIPAA-compliant web forms. The core offering consists of HIPAA Forms Basic (free, limited to 1 form and 25 submissions/month) and Standard tier subscriptions (unlimited forms and submissions at $65/month, $190/quarter, or $715/year). Optional file upload add-ons are available for $30/month or $300/year additional, combining with Standard plans to create Plus File Upload tiers. A one-time $100 setup service is also offered. The plugin integrates with Caldera Forms (free) or Gravity Forms (premium) form builders, encrypts and transmits form data to HIPAA-compliant storage via the company's API, and allows secure PDF generation of submitted forms. The company is developing Akashic Health Records as a future patient-centered coordination platform and portal to extend beyond form collection into broader healthcare information management.
Differentiator
Problem solved
Functional benefit
Brands
- Akashic Health Records: A patient-centered, real-time healthcare coordination platform and patient portal embedded within an organization's WordPress domain, designed to help organizations collect information, manage information, coordinate care, and engage patients
Products and services
- HIPAA FORMS
- HIPAA FORMS Setup Service
Quantifiable outcome
- Patients spend over 20 minutes on average filling out forms in office
Companies that use HIPAA Compliant Web Forms
Customer profileNamed customers1 record
Segments3 records
Ideal customer profiles3 records
HIPAA Compliant Web Forms technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
Integration3 records
Feature8 records
HIPAA Compliant Web Forms partnerships and signals
Strategic signalPartnerships
Two partnerships are on record, tiered core.
- Caldera FormscoreFree WordPress form builder plugin integrated with HIPAA Forms. Preferred form builder due to being free and simple to use. Forms created with Caldera can be designated as HIPAA compliant with a single checkbox.
- Gravity FormscorePremium WordPress form builder plugin integrated with HIPAA Forms. Popular paid form builder that can be designated as HIPAA compliant. No additional extensions needed for HIPAA compliance.
Scale indicators3 records
Recent moves5 records
Expansion highlights3 records
HIPAA Compliant Web Forms competitors and assessment
Company assessmentEmerging players
- WPForms: Popular WordPress form builder with a growing ecosystem of add-ons; relevant peer as another WordPress-native form option that could expand into HIPAA-compliant tiers over time.
- 123FormBuilder: Web-based form builder with HIPAA-compliant option and healthcare templates; comparable in secure healthcare data collection, with a similar self-serve SMB orientation.
- Formidable Forms: Advanced WordPress form builder with calculation and view features; comparable in targeting WordPress-based form workflows and a potential add-on HIPAA partner or competitor.
Broad incumbents
- Typeform: Widely-used conversational form and survey platform with healthcare use cases; competes for online patient intake and registration workflows though not WordPress-native.
- Tebra (formerly PatientPop): Practice growth and EHR-adjacent platform for independent healthcare practices; relevant as an adjacent buyer of HIPAA-compliant intake and forms workflows in the SMB healthcare segment.
- SurveyMonkey (Healthcare): Large-scale survey and form platform with HIPAA-compliant enterprise offering; competes for healthcare data capture use cases with a much broader product portfolio.
- Gravity Forms: Leading premium WordPress form builder that HIPAA Forms integrates with; a potential competitor if it ships native HIPAA features, but currently a channel partner rather than a rival.
Direct peers
- Formstack: Healthcare-focused online forms and workflow automation with HIPAA compliance and BAA support; comparable in targeting healthcare forms and secure data capture, though broader than WordPress-only.
- JotForm: Offers a HIPAA-compliant tier of its online form builder targeted at healthcare organizations; directly competes in the same secure-form-for-healthcare-E-PHI category with a broader, non-WordPress platform.
- Cognito Forms: Online form builder with a HIPAA-compliant offering and BAA for healthcare customers; competes for the same healthcare form collection use case with similar encryption and compliance positioning.
Market position
Strengths4 records
Weaknesses4 records
Competitive moat5 records
Key risks6 records
Key highlights6 records
Customer concentration
HIPAA Compliant Web Forms compliance and trust
Trust signalCompliance1 record
HIPAA Compliant Web Forms financial estimates
Financial estimateRevenue estimate
Valuation estimate
HIPAA Compliant Web Forms leadership team
Management profileNumber of profiles
Profiles1 record
HIPAA Compliant Web Forms funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
HIPAA Compliant Web Forms M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about HIPAA Compliant Web Forms
What does HIPAA Compliant Web Forms do?
Code Monkeys LLC sells HIPAA Forms, a WordPress plugin plus API service that converts forms built with Caldera Forms or Gravity Forms into HIPAA-compliant forms by encrypting submissions and storing E-PHI on HIPAA-compliant infrastructure separate from the customer's hosting server. The product includes drag-and-draw digital signatures, secure password-protected PDF generation, role-based form separation by clinic or doctor, audit-grade access logging, and a Business Associate Agreement (BAA). Subscriptions are offered as a free Basic tier (1 form, 25 submissions/month) and Standard or Plus paid tiers (monthly, quarterly, or annual), with an optional $100 one-time Setup Service for installation and configuration.
Is HIPAA Compliant Web Forms a public or private company?
HIPAA Compliant Web Forms is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was HIPAA Compliant Web Forms founded?
HIPAA Compliant Web Forms was founded in 2018.
Where is HIPAA Compliant Web Forms based?
HIPAA Compliant Web Forms is headquartered in Hammond, United States, in the North America region.
How does HIPAA Compliant Web Forms make money?
Four revenue lines are on record. Basic Free Tier is the primary driver. The others are standard Subscription Plans, plus File Upload Subscription and setup Service.
Who are HIPAA Compliant Web Forms's main competitors?
Emerging players on record are WPForms, 123FormBuilder and Formidable Forms. Broad incumbents are Typeform, Tebra (formerly PatientPop), SurveyMonkey (Healthcare) and Gravity Forms. Direct peers are Formstack, JotForm and Cognito Forms.
Does HIPAA Compliant Web Forms have an API?
Yes. The HIPAA FORMS Service API enables secure, encrypted transmission and storage of HIPAA-compliant web form data. The API handles form submissions by encrypting data before transmission and storing it on HIPAA-compliant encrypted storage. The API performs domain, license key, and BAA agreement validation on each request. Forms can only be submitted and viewed from the domain associated with the license key. The API is accessed through the WordPress plugin, which overrides the default form submission process.
What industry is HIPAA Compliant Web Forms in?
HIPAA Compliant Web Forms's product category is HIPAA Compliance Software. Its primary akta.pro industry code is HLACACAE, Patient Access, Registration & Intake (Front-End RCM). Its NAICS code is 5132 and its SIC code is 7372.