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Medical Health Questionnaire

FormFire’s Medical Health Questionnaire (MHQ) makes collecting personal information and health history quicker for Employees and eliminates time-consuming scrubbing for Brokers.

Medical Health Questionnaire

Rather than filling out multiple Carrier applications with dozens of overlapping questions, our MHQ walks through a series of specific medical questions as paper applications might, collecting all details in one digital application.

Brokers can use FormFire’s Information Preloader to populate basic demographic information on behalf of Employees before they create an account. Employee information is saved year-to-year, making future applications even more efficient by only requiring simple updates.

FormFire’s Data Mapping Engine ensures the data collected in the MHQ is properly populated onto Carrier-specific applications as if the Employee completed the form by hand. This process can be replicated countless times for multiple Carriers, streamlining the quoting process and saving you valuable time.

Medication Database

FormFire maintains a list of FDA-approved medications and dosages and links them to associated medical conditions. This database saves Employees’ time and ensures accurate medication information is entered.

Error Check

As an Employee moves through the questionnaire, all required fields are marked. However, we realize an Employee may not have all their details and may have to come back later. For that reason, before signing, the Employee’s data goes through a customized Error Check. Any missing or conflicting information can be corrected here without going back through the entire questionnaire. This eliminates time-consuming scrubbing for Brokers.

Ensuring the information sent to Carriers is consistent and complete reduces the number of calls back to Brokers or Employees themselves, saving time and aggravation while providing more accurate quotes.


To capture a legally binding, Carrier-accepted ESIGN compliant signature, FormFire’s eSignature saves time and ensures compliance by allowing Employees to electronically sign using their mouse.

FormFire’s Medical Health Questionnaire is convenient, time-saving and secure. Combined with our Integrated ACA and Level-Funded Products tool, Brokers have the advantage of comprehensive market coverage, allowing their Groups to compare all available options across Carriers to determine what best meets their needs.

Security You Can Trust

Collecting Employee medical information requires a lot of care to ensure collection and storage practices are compliant and secure. FormFire offers a compliant way to populate Carrier forms for Groups that ensures the security of Employer Groups’ data is unparalleled.

FormFire is HIPAA and HITECH compliant, and HITRUST certified. To learn more about FormFire’s security practices, click here.