HealthForms Website Terms of Use
Effective Date: April 2026
These Terms of Use explain your rights and responsibilities when using our service, including payment policies, privacy protections, and what you can expect from the form completion process.
By using HealthForms or clicking to accept the Terms of Use, you accept and agree to be bound by these Terms. If you do not agree, do not use HealthForms.
While Datavant powers HealthForms, healthcare organizations may customize how the service appears with their own branding or web address.
You must be 18 years or older and reside in the United States to use HealthForms. By using HealthForms, you’re confirming you meet these requirements.
PHI submitted through HealthForms is collected and processed by Datavant on behalf of your healthcare provider and is subject to the terms of a Business Associate Agreement (“BAA”) between Datavant and your healthcare provider, as well as applicable laws, including the Health Insurance Portability and Accountability Act (“HIPAA”). For more information about how your healthcare provider uses and discloses your PHI, please refer to your provider’s Notice of Privacy Practices.
In order to provide the HealthForms website and related functionality, Datavant may use personnel located outside of the United States to access and process information on a limited basis. Any such access is restricted to viewing and processing only, subject to our BAA with your provider, and all PHI will remain stored on systems located within the United States.
Any personal information submitted through HealthForms that does not constitute PHI is subject to our Privacy Policy. By using HealthForms, you consent to our collection, use, and disclosure of your information as described in this section and in the Privacy Policy, as applicable.
You affirm that you are authorized to upload relevant information to HealthForms and obtain any and all medical information that may be included in or attached to the completed health form.
Before submitting a HealthForms request, please ensure that you have recent medical records with your provider related to your form and are requesting forms for yourself or someone you're legally authorized to represent.
If you have questions about your medical information or clinical recommendations made in a health-related form, please reach out to your healthcare provider directly.
For questions regarding these Terms, please contact:
Email: Legal@datavant.com | Mailing Address: Datavant, LLC, 2222 West Dunlap Avenue, Suite 250, Phoenix, Arizona 85021
What is HealthForms?
Datavant’s HealthForms is a secure online solution that helps you request completion of health-related forms from your healthcare provider. Whether you need immunization verification, medical leave forms, or other paperwork completed, HealthForms streamlines the process by allowing you to submit your request and receive completed forms digitally, whenever possible. Datavant assists your healthcare provider in completing your forms using information in your medical records. All medical judgments, determinations, and approvals reflected in any completed form are made solely by your healthcare provider.These Terms of Use explain your rights and responsibilities when using our service, including payment policies, privacy protections, and what you can expect from the form completion process.
Acceptance of these Terms
These Terms of Use (“Terms”) are entered into by and between you and Datavant, LLC ("Company," "we," or "us"). These Terms govern your access to and use of the HealthForms website (“HealthForms”), including any content, functionality, and services offered via HealthForms.By using HealthForms or clicking to accept the Terms of Use, you accept and agree to be bound by these Terms. If you do not agree, do not use HealthForms.
While Datavant powers HealthForms, healthcare organizations may customize how the service appears with their own branding or web address.
You must be 18 years or older and reside in the United States to use HealthForms. By using HealthForms, you’re confirming you meet these requirements.
Purpose of HealthForms
HealthForms is intended solely for individuals to submit requests to their healthcare providers to complete medical verification forms, including but not limited to disability forms, family and medical leave documentation, school or childcare-related health forms and other similar forms. Datavant acts as a service provider to, and on behalf of, your healthcare provider in facilitating the completion of your requested health-related forms. Datavant facilitates and performs administrative aspects of form completion on behalf of your healthcare provider, based solely on information documented in your medical record. Datavant does not provide clinical care, certification of a medical condition, or make independent medical determinations.Security
You agree to provide accurate, current, and complete information when using HealthForms. If you believe that any unauthorized or inappropriate use of HealthForms has occurred, please contact us immediately. We reserve the right to restrict or discontinue access to HealthForms for any reason, including violation of these Terms.Payment for Services
Fees may be charged by Datavant on behalf of your healthcare provider. By submitting a request, you agree to pay any applicable fees as displayed at the time of submission. Payment must be made through HealthForms using an approved payment method before your request will be processed. All fees are non-refundable once the request has been submitted, regardless of the outcome or your provider’s response, unless otherwise required by law.Privacy and Use of Personal Information
HealthForms involves the collection and processing of both personal information and protected health information (“PHI”).PHI submitted through HealthForms is collected and processed by Datavant on behalf of your healthcare provider and is subject to the terms of a Business Associate Agreement (“BAA”) between Datavant and your healthcare provider, as well as applicable laws, including the Health Insurance Portability and Accountability Act (“HIPAA”). For more information about how your healthcare provider uses and discloses your PHI, please refer to your provider’s Notice of Privacy Practices.
In order to provide the HealthForms website and related functionality, Datavant may use personnel located outside of the United States to access and process information on a limited basis. Any such access is restricted to viewing and processing only, subject to our BAA with your provider, and all PHI will remain stored on systems located within the United States.
Any personal information submitted through HealthForms that does not constitute PHI is subject to our Privacy Policy. By using HealthForms, you consent to our collection, use, and disclosure of your information as described in this section and in the Privacy Policy, as applicable.
User Responsibilities
You agree to use HealthForms only for lawful purposes and in accordance with these Terms. Specifically, you agree not to:- Submit false, incomplete, or misleading information.
- Request that a form be completed for anyone other than yourself or an individual you are legally authorized to act on behalf of.
- Interfere with or disrupt the operation of HealthForms.
- Introduce any viruses, trojan horses, worms, logic bombs, or other material that is malicious or technologically harmful.
- Attempt unauthorized access to any part of HealthForms.
- Use HealthForms for commercial purposes or on behalf of third parties.
You affirm that you are authorized to upload relevant information to HealthForms and obtain any and all medical information that may be included in or attached to the completed health form.
Before submitting a HealthForms request, please ensure that you have recent medical records with your provider related to your form and are requesting forms for yourself or someone you're legally authorized to represent.
Intellectual Property Rights
All content on HealthForms, including text, graphics, logos, and software, is the property of the Company or its licensors and is protected by copyright and other laws. You may use HealthForms for personal, non-commercial purposes only.Third-Party Services and Links
HealthForms may contain links to third-party websites or services. The Company is not responsible for the content or practices of any third party and your use of such services is at your own risk.Disclaimers
- Datavant is not a healthcare provider, does not provide medical advice, and does not participate in clinical decision-making or judgments about your health or ability to perform work or other activities.
- Datavant does not guarantee that your form request will be approved, completed within a specific time, or accepted by any employer, school, insurer, or government agency.
- Datavant does not assume responsibility or any liability whatsoever for the completeness, accuracy, or availability of the information supplied in the form. The completeness and availability of your medical records are the responsibility of your healthcare provider.
- Form rejections or benefit denials are outside our control and responsibility.
- HealthForms and services are provided "as is" without warranties of any kind. While we strive for reliability, temporary service interruptions may occur.
- HealthForms uses automated tools and machine-learning technologies to assist in processing and completing forms. Any information generated by these tools is preliminary and is subject to review and approval by your healthcare provider.
- Datavant does not guarantee the accuracy, completeness, or reliability of any automated outputs generated by the platform.
Limitation of Liability
To the fullest extent allowed by law, the Company shall not be liable for any damages resulting from:- Delays or failures by providers to complete forms.
- Rejection of completed forms by third parties.
- Errors or omissions in form content.
- Unauthorized access to your information despite our safeguards.
Indemnification
You agree to indemnify and hold harmless the Company and its affiliates from any claims or losses resulting from your use of HealthForms, violation of these Terms, or infringement of any third-party rights.Governing Law and Jurisdiction
These Terms are governed by the laws of the State of Delaware. All disputes shall be resolved exclusively in the courts located in Delaware unless otherwise required by law.Arbitration
At the Company’s sole discretion, disputes may be resolved by binding arbitration in accordance with the rules of the American Arbitration Association.Modifications and Termination
The Company reserves the right to modify or discontinue HealthForms at any time without notice. We may also revise these Terms periodically. Changes are effective immediately when we post them, and apply to all subsequent access to and use of HealthForms (except changes to the arbitration clause, which will not apply to disputes that the Company has been notified of prior to making the change). Continued use of HealthForms after changes means you accept the new Terms.Entire Agreement
These Terms, along with our Privacy Policy, constitute the entire agreement between you and the Company. These Terms do not create a provider-patient relationship. All clinical decisions are made solely by your healthcare provider.Getting Help
For website issues, payment problems, or submission questions, please contact:If you have questions about your medical information or clinical recommendations made in a health-related form, please reach out to your healthcare provider directly.
For questions regarding these Terms, please contact:
Email: Legal@datavant.com | Mailing Address: Datavant, LLC, 2222 West Dunlap Avenue, Suite 250, Phoenix, Arizona 85021