---
title: Telehealth Platform Request Form Template - Paperform
description: Collect detailed requirements for telehealth platform solutions including provider capacity, scheduling integration, prescription modules, insurance billing, and HIPAA compliance specifications.
url: "https://paperform.co/templates/telehealth-platform-request-form"
type: static
generatedAt: "2026-03-28T00:45:22.293Z"
---

[← Back to free form templates](/templates/)    ![Telehealth Platform Request Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/telehealth-platform-request-form.png)
    [Preview](https://_preview.paperform.co/ai-template/telehealth-platform-request-form) [Use this template for free](/create?ai-template=telehealth-platform-request-form)    [Healthcare & Medical Forms](/templates/category/healthcare/)[Information Technology](/templates/category/it/) [Software & SaaS](/templates/industry/software-saas/)[Healthcare](/templates/industry/healthcare/)[Telehealth](/templates/industry/telehealth/)[IT Services](/templates/industry/it-services/) [Manager](/templates/role/manager/)[Physician](/templates/role/physician/)[Healthcare Administrator](/templates/role/healthcare-admin/)[IT Professional](/templates/role/it-professional/)[Operations Manager](/templates/role/operations-manager/)     About this free form template
### Streamline Your Telehealth Platform Selection with Paperform

Choosing the right telehealth platform is critical for healthcare organizations looking to expand virtual care services. This **Telehealth Platform Request Form** helps IT teams, practice managers, and healthcare administrators gather detailed requirements and evaluate solutions that meet clinical, technical, and compliance needs.

Whether you're a medical practice, hospital system, mental health clinic, or specialty provider, this template captures essential information about provider count, scheduling integration needs, prescription workflows, insurance billing requirements, and HIPAA compliance specifications—ensuring your IT team can source the right platform for your organization.

#### Why This Template Works for Healthcare IT Teams

This form is designed specifically for healthcare organizations navigating the complex landscape of telehealth technology. It helps you:

 - **Define provider and patient capacity requirements** to ensure the platform scales with your practice
 - **Specify scheduling and calendar integration needs** to streamline appointment workflows
 - **Evaluate prescription management modules** for e-prescribing and controlled substance handling
 - **Clarify insurance billing and claims integration** requirements for revenue cycle management
 - **Document HIPAA compliance and security standards** to protect patient data and meet regulatory obligations

By collecting comprehensive requirements upfront, your team can evaluate vendors more effectively and implement a solution that truly supports your virtual care goals.

#### Automate Your Telehealth Platform Procurement with Stepper

Once submissions come in, you can use [Stepper](https://stepper.io) to automate your internal procurement workflow. Route requests to IT security teams for compliance review, notify finance for budget approval, trigger vendor outreach and demo scheduling, and keep stakeholders updated throughout the evaluation process—all without manual follow-up.

Paperform is trusted by healthcare organizations worldwide for secure, professional forms and workflows. While this template helps you collect telehealth platform requirements, please note that Paperform itself is not a HIPAA-compliant solution for collecting protected health information (PHI).
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