CareSubmit Online Patient Forms

Secure Online Patient Forms || Appointments, Requests, Rx || You Need To Be HIPAA Compliant || Optimize Staff Workflow || Save Practice Overhead $$

Secure Online Patient Forms - Intake, Appointments, Requests, More!

Patient Connected Services

Your patients and staff need secure and easy communication solutions.

Forms and Requests

CareSubmit is secure Online patient forms and requests - Appointments, Forms, Rx, Pre Reg, BillPay, more.

Security HIPAA

Patients expect your practice to secure their information and allow them to submit on both desktop and mobile.

Save Money

Your staff needs easy to execute workflow solutions. Your practice deserves the cost savings.

What is CareSubmit?

Smart Tools for Patients and Staff

CareSubmit is not a portal. Portals are costly, cumbersome, and only used by a small fraction of a medical practice's patients. What CareSubmit IS is a smart solution for any medical practice wanting custom intake forms, appointment requests, daily communications, and patient processing - securely, Online.

  • Be HIPAA Compliant
  • Custom Forms/Solutions
  • We take Care of Everything
  • Easy for Patients and Staff
  • Easily Updated
  • Add to ANY website

Simple Beautiful

A smart way to make any medical practice website interactive.

Yes, CareSubmit is designed to work with any website. Even better, we support your CareSubmit services regardless of your website support.
Yes! CareSubmit allows us to dig into your specific needs and tailor your forms and requests exactly the way you want them.
Absolutely! CareSubmit forms work on tablets, phones like iPhone, and, of course, desktops and laptops.

Go Paperless

Process Efficiency

Happy Staff

Optimized Workflow

More Patients

Growth Through Efficiency


Features & Benefits

Secure Healthcare Cloud Patient Forms & Communications Solutions.

Trusted Company

CareSubmit is Vital Element, Inc. service. Vital Element has been providing web services exclusively to the medical industry for over 15 years.

Multi Screen Compatible

Forms can be securely submitted and staff can securely view results from phones, tablets, and desktop computers.

Cloud Platform

CareSubmit services are managed and secured in the Cloud. This allows you to take advantage of the power, security, and low cost of a Cloud service rather than attempting on your own.

Systems Independent

CareSubmit works with any Portal, EMR/EHR, and website - independently. CareSubmit adds value independent of your current systems.

Customizable Solutions

Appointments, General Requests, Registration -- ANY type of Form or Request -- with secure, smart routing of notifications to pre-determined staff -- and logs/alerts for views and processed records by staff.

World Class Support

We've taken the complexity out of providing your practice with patient connected services and your subscription comes with ongoing support.


Affordable Subscription

Cloud computing subscription means we take care of everything.

CareSubmit Basic

$599Per YEAR

  • BAA Business Associate Agreement
  • 1 Staff User
  • APPOINTMENT Requests Form
  • GENERAL Requests Form

CareSubmit Pro

$999Per YEAR

  • BAA Business Associate Agreement
  • 5 Staff Users
  • SMART Routing Staff Notifications
  • APPOINTMENT Requests Form
  • ADD FORMS General, Rx, Physician Referrals, Lab/Test Results Requests, Basic Pre-Registration, Survey, Testimonial Submit

CareSubmit Elite

$1499Per YEAR

  • BAA Business Associate Agreement
  • 10 User Access
  • SMART Routing Staff Notifications
  • APPOINTMENT Requests - Scheduling
  • ADD FORMS All "PRO" forms plus Advanced Pre-Registration, Medical History, Medical Records Release, and Advanced Customized Complex Forms*
    *some forms may require additional build fees
Schedule a call with a CareSubmit Expert

We'll Answer Questions and
Get You Started!