How to set up your contact form for patient privacy

Your contact form is a convenient way for patients to get in touch, but it's not the best channel for sharing sensitive health details. This guide walks you through adding a privacy disclaimer, enabling a compliance checkbox, and customizing the consent message so patients know how to reach you safely.

 

How to Add a Privacy Disclaimer to Your Contact Form

Adding to the subheading section of your contact form is a great way to let patients know that the contact form isn't the right place to share personal health information.
 

1. After logging into your Jane Websites account, navigate to the page on your site that contains your contact form.
2. Click the pencil icon on the contact form block to edit your contact form.
3. In the Subheading field, enter a message that discourages patients from sharing sensitive health details. For example: "Please don't include any personal health information in this form. To share health details securely, please book an appointment."
4. Click the Update Block button to save your changes.

How to Enable the Compliance Checkbox

Enabling the compliance message option adds a checkbox to the bottom of your contact form that patients must check before they can submit it. This is a great way to reinforce that the contact form isn't the right place to share personal health information.
 

1. After logging into your Jane Websites account, navigate to the page on your site that contains your contact form.
2. Click the pencil icon on the contact form block to edit your contact form. 
3. Scroll down to the Compliance Message section.
4. In the Compliance Message section, enter the label that will appear above the checkbox. For example: "Please check the box below before submitting this form."
5. Review the fields your form is collecting (phone number, email, etc) and uncheck the ones that aren't necessary for your clinic's needs.
6. Click the Update Block button to save your changes.

How to Customize the Compliance Checkbox Message

You can replace the generic compliance message in your contact form with a more specific consent statement to better reflect your clinic's privacy obligations.
 

1. After logging into your Jane Websites account, click Admin> Settings.
2. In the left-hand sidebar, scroll down and click Translations.
3. Locate the field that reads "Yes, I want to submit this form and agree to the terms of use."
4. Replace the existing text with your updated consent message. For US-based clinics, you might use something like: "I understand that this form is not HIPAA compliant and should not be used to submit protected health information (PHI). By submitting this form, I consent to my contact information being used to respond to my inquiry." For Canadian clinics, adjust the wording accordingly to reflect PIPEDA or relevant provincial privacy legislation.
5. Click out of the translation field to save. You should see a Translation Saved confirmation appear at the top left corner of the page.
6. Navigate back to your contact form page and refresh the browser to see the updated checkbox message.

That's all there is to it! Your contact form now includes a privacy disclaimer, a required compliance checkbox, and a consent message that reflects your clinic's obligation to patient privacy. Now, patients will have a clearer understanding of what information they should be submitting to you in a contact form.