Privacy Policy
Last updated: November 23, 2025
MyHealthForm.com (“we,” “us,” or “our”) provides a fast, simple, and compliant way for in-home caregivers to obtain state-required health screenings confirming they are “free from communicable diseases.” We take your privacy extremely seriously, especially because you are providing sensitive personal and health-related information.
This Privacy Policy explains what information we collect, how we use it, how we protect it, and the rights you have regarding your data.
By using MyHealthForm.com, you agree to the practices described in this Privacy Policy.
1. Information We Collect
We collect information in the following categories:
1.1 Personal Information
Name
Email address
Phone number
Address (if required for state verification)
Account login details (username, password, SMS verification)
1.2 Health-Related Information
Because MyHealthForm.com provides medical screening verification, we may collect:
Health screening results
Communicable disease clearance status
Date of test or screening
Provider verification details
Certificate or documentation you provide or upload
Note: MyHealthForm.com is not a covered entity under HIPAA. However, we treat your information with the same level of respect, confidentiality, and security.
1.3 Payment Information
When you make a purchase, we collect payment data through Stripe, including:
Card type (last 4 digits)
Billing zip code
Payment status
Transaction IDs
We never store or see your full credit card number.
1.4 Automatically Collected Information
IP address
Browser type
Device type
Log files
Pages visited
Actions taken on the site
We use analytics tools (like Google Analytics) for performance and security.
2. How We Use Your Information
We use your information to:
Process caregiver health screenings
Verify your identity through SMS
Generate official MyHealthForm health clearance documentation
Communicate with you (update emails, reminders, confirmations)
Provide support to caregivers and home care agencies
Improve Our Technological Platform
Handle billing, payments, and receipts
We may also anonymize data for statistical and compliance reporting.
We never sell or rent your personal information.
3. How Your Information Is Stored & Protected
We use modern, industry-standard security protections including:
3.1 Encryption
Data is encrypted in transit (HTTPS)
Sensitive information is encrypted at rest
3.2 Secure Authentication
SMS-based two-factor login
Secure password hashing
Session security and automatic expiration
3.3 Secure Infrastructure
Hosted on secure servers with firewall protections
Routine monitoring for vulnerabilities
Least-privilege access controls for staff
Regular backups and redundancy
3.4 Limited Access
Only authorized personnel who require access for verification, support, or technical reasons may view your data.
We treat all information with medical-grade confidentiality.
4. Sharing of Information
We may share your information in the following limited scenarios:
4.1 With Healthcare Providers
If you submit documentation from a licensed professional, it may be reviewed for verification.
4.2 With Home Care Agencies (ONLY With Your Permission)
If your agency has requested your clearance, we may securely provide:
Clearance verification
Your name
Confirmation that you are “free from communicable diseases”
Screening date
We never provide more information than necessary.
4.3 With Service Providers
We use trusted third-party providers for:
Payment processing (Stripe)
SMS delivery (Twilio)
Hosting and infrastructure
Analytics
Customer support systems
These providers are contractually obligated to protect your information.
4.4 When Required by Law
We may disclose information to comply with:
State caregiver registry requirements
Legal investigations
Subpoenas or government orders
We only share what is legally required.
5. Your Rights and Choices
Depending on your state, you may have the right to:
Access the personal information we hold about you
Request corrections
Request deletion (unless required to keep records for compliance)
Request a copy of your health clearance data
Opt out of marketing emails (we send very few)
We will respond to all requests within reasonable timeframes.
6. Data Retention
We keep information for as long as necessary to:
Provide your health clearance
Meet state compliance requirements
Support agency verification
Maintain accurate records for legal or auditing purposes
You may request deletion of your account, but certain data may need to be retained for compliance.
7. Children’s Privacy
MyHealthForm.com is not intended for individuals under 18. We do not knowingly collect information from minors.
8. Cookies and Tracking
We use cookies to:
Keep you logged in
Improve site performance
Analyze traffic and security
You can disable cookies through your browser settings, but certain features may not function correctly.
9. SMS Communications
By providing your phone number, you consent to:
Verification texts
Account security messages
Important updates related to your screening
Message and data rates may apply.
You can opt out of non-essential messages at any time.
10. Changes to This Privacy Policy
We may update this Privacy Policy occasionally. Changes will be posted on this page with a new “Last Updated” date.
Your continued use of the site means you accept the updated version.
11. Contact Us
If you have questions about this Privacy Policy or your personal information, please contact us:
MyHealthForm.com
Email: [email protected]
Website: https://myhealthform.com