Not sure if it would be HIPAA compliant. But, you probably need to use some type of 3rd party software. If I recall when I get something from Survey Monkey, I can only fill it out and click enter at the end. The results would go to you. You can set up skip page and skip question logic, etc.

https://www.surveymonkey.com/pricin...rce2=take-a-tour&ut_source3=megamenu

Bert
Pediatrics
Brewer, Maine