Medical Forms Automations

Dealing with sensitive data and zero margin error can be a hustle. In medical clinics, hospitals, and examination facilities, many compulsatory documents must be filled in, stored, or sent to authorities. We can automate your website with forms that allow your customers to send documents or specific forms. The output files can be sent to your CRM, email, or secured storage – all HIPAA-compliant solutions. This page is intended to showcase document automation for a medical examination center, more precisely I693 Form.

Form I-693 is a medical examination form used by the United States Citizenship and Immigration Services (USCIS). It is completed by a designated civil surgeon and is required for individuals applying for certain immigration benefits. The form includes information about the individual’s medical history and examination results, including any communicable diseases of public health significance.
Submitting this form will NOT send you any data unless you drop us a line at hello@goinglive.pro

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I693 Form Automation (Medical application)

Please Select Office Address
Office *
Street Number and Name
City or Town
Please fill in the data making sure the information provided is correct
Your Full Name
Family Name (Last Name)
Given Name (First Name)
Middle Name
Physical Address
Street Number and Name

Type

Number
City or Town
COUNTY
ZIP Code
State *
Please fill in the data making sure the information provided is correct
Other Information
Date of8 Birth

Gender

City/Town/Village of Birth
Country of Birth
Alien Registration Number
A-Number (if any)
USCIS Online Account No
(if any)
Selected Month
0.00
Applicant’s Statement (select A. or B.)
Please specify language *
Applicant’s Statement Regarding the Preparer
Preparer Details
Preparer’s Family (Last Name)
Preparer’s Given (First Name)
Preparer’s Business or Organization Name (if any)
Street Number and Name

Type

Number
City or Town
ZIP Code
State
Province
Postal Code
Country
Daytime Telephone
Mobile Number
Email
Contact Information
Applicant’s Daytime Telephone Number
Applicant’s Mobile Telephone Number (if any)
Applicant’s Email Addressu003cbru003e(if any)
Additional Information
Do you have health insurance?  *
Full Name of the primary person associated with the insurance plan
Date of birth of the primary person associated with the insurance plan
Describe Your Relationship to the Insured
Name of Insurance
Insurance Member ID
Insurance Group ID
+40 722151540

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Lisa D.

Great job

Mircea helped me with my new website. My old site was slow and old-fashioned. I am very happy with the results.

Hanna A.

Document automation

Thank you for helping us in generating the day-to-day documents.

Andrew R.

The ones for the job!

Fast delivery, doing more than asked, and fair pricing

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Helped me with my SEO

I was struggling to rank in google. After the website upgrade, results are starting to see. Thank you!

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