Purpose
State why the declaration is collected (screening, access control, or public health reporting), who will view the information, and how results will affect participation or access decisions.
Use a Health Declaration to document health-related disclosures, reduce transmission risk, and create a record for incident response and regulatory review. It provides a clear, reproducible statement of a person's recent symptoms or exposures for workplace, travel, or event screening purposes.
Many organizations collect Health Declarations when assessing entry or participation risk; this includes employers, event organizers, schools, and transportation providers.
| Field | Configuration |
|---|---|
| Form or Workflow Type and Mode | Single-page form or multi-step wizard for conditional flows. |
| Required Fields and Validation | Enforce name, date, contact, symptom checkbox, signature. |
| Authentication Method | Email link, SMS code, or stronger KBA as needed. |
| Routing and Notifications | Send completed records to HR, medical review, and archive. |
Digital submission requires a platform supporting secure forms, e-signature, and access logging for compliance and traceability.
State why the declaration is collected (screening, access control, or public health reporting), who will view the information, and how results will affect participation or access decisions.
Specify the population covered, applicable locations, and time window for disclosures (for example, symptoms or exposures within the previous 14 days), and any follow-up procedures.
Include a clear consent clause stating agreement to screening, electronic records under ESIGN, and permission for limited contact for follow-up or contact tracing.
Use simple, specific questions with checkbox options and space for brief explanations; avoid ambiguous phrasing and include date fields for onset information.
Allow upload of supporting documents such as test results, vaccination records, or clinician notes; define accepted formats, file size limits, and submission deadlines.
Record signer identity, timestamps, IP addresses, and action logs; preserve a machine-readable certificate of completion and storage location to support legal admissibility.
Submit within 24–72 hours before entry or event.
Provide upon arrival or via pre-event online submission.
Complete declarations per carrier or destination rules before departure.
Employees must submit up-to-date declarations before workplace reentry.
Allow 24–48 hours for review and verification in typical workflows.
Define fields, consent language, and required attachments.
Publish form link or distribute paper copies to participants.
Review responses and follow up on flagged items promptly.
Export signed records to secure storage and apply retention.
A regional property management firm used a digital Health Declaration to screen attendees at showings and manage tenant access without in-person forms.
A healthcare clinic integrated Health Declarations into patient intake to capture symptom screening and consent before appointments.
Oversees patient intake and requires Health Declarations to triage appointments, document consent for telehealth, and coordinate with medical staff. Must ensure data handling meets HIPAA and that e-sign consents are documented for each patient visit.
Manages attendee screening, uses Health Declarations to enforce entry rules, track potential exposures, and coordinate notifications. Needs configurable questions, bulk send capability, and retention policies aligned with local public-health guidance.
| signNow | DocuSign | Adobe Sign | PandaDoc | HelloSign | |
|---|---|---|---|---|---|
| Starting Price | $8/user/mo | $15/user/mo | $14/user/mo | $19/user/mo | $15/user/mo |
| Free Trial | Yes, 7-day free trial, no credit card required | Varies by vendor | Varies by vendor | Varies by vendor | Varies by vendor |
| Bulk Send | Yes (plan dependent) | Yes (plan dependent) | Yes (plan dependent) | Yes (plan dependent) | Varies |
| Audit Trail | Yes | Yes | Yes | Yes | Yes |
| HIPAA Compliant | Yes | Yes | Yes | No | No |
| Envelope Cap | No cap | 100 envelopes/user/year | Varies | Varies | Varies |