The enrollment form is completed across three roles: medical staff, the patient, and the prescriber. FastPass coordinates each step within a single workflow, maintaining a continuous, auditable record from start to submission.

This is a typical patient support program website. The prescriber's office clicks "Access the enrollment form" and opens a digital version of the manufacturer's approved enrollment form. FastPass simply appends a URL to any existing form, making it available for direct access on a site, portal, or shared link. No IT integration required.

The medical staff enters what they know: patient name, date of birth, and contact information. Required fields are enforced by the system, so nothing gets missed.

The medical staff enters the prescriber's information once and selects "Learn." The information is stored locally in the browser. Next enrollment, just click "Fill." No cloud storage. Reduced data exposure. Just speed and easy adoption.

The medical staff sends the form to the patient first, then the prescriber. The NPI is already verified in the system. Channels include email and SMS.

The patient receives an email or text message inviting them to complete their section of the enrollment form. Branding, messaging, and channels are fully customizable per manufacturer and program.

Patients enter their address and insurance details, then upload their insurance card directly into the form. Required fields and attachments are enforced by the system.

The patient reviews consent language and signs electronically. Date-stamped and audit-tracked. Using the consent authorization statements your legal team approves.

The prescriber receives an email notification. They click through and land directly on the form. No separate portal. No new login.

The prescriber's identity and prescribing authority are verified before access to the e-prescribing system of record.

The prescriber sees everything the patient filled out but cannot edit those fields. Field-level permissions are controlled without changing the legally approved template.

The prescription section now opens a certified ePrescribing experience directly within the form. The prescriber remains within workflow. The eRx runs in parallel, in the same session, on a familiar clinical workflow they would use in any certified prescribing platform.

Patient information entered in the form is used within the ePrescribing workflow. Medication history may be available based on network response following patient identification. Drug interaction screening is performed within the ePrescribing platform.

The prescriber searches for the medication, sets quantity and instructions, and adds it to the draft. Same clinical workflow they would use in a certified prescribing platform.

Electronic signature designed to meet Part 11 requirements. The digital seal helps prevent duplicate prescriptions and links to a full audit trail via QR code. Who signed what, when, and from which profile.

At submit, a completed copy of the submitted Patient Enrollment Form (PEF) can be delivered to key stakeholders, including the patient, medical staff, prescriber, and hub or designated intake pharmacy. This reduces uncertainty about what happened and whether the form was submitted. Every party in the workflow has a record of what was submitted, when it was submitted, and by whom.

Each step of the enrollment workflow is visible in one view. Who filled out which section, who signed, when each handoff occurred, and which steps were complete. Think of it like a digital receipt, but for the entire multi-party enrollment process. This audit trail is accessible anytime through the QR code on the prescription seal.

The submitted PEF pages, the insurance card, clinical notes, and any other attachments are delivered to the client's system of record. In this example, Salesforce receives the full document package as viewable attachments on the patient record. No manual uploads or scanning required. The documents arrive alongside the enrollment data, ready to reference.

Beyond the documents, the actual data on the form can be mapped into the system of record or delivered as a data package. Patient name, date of birth, prescriber NPI, drug name, quantity, signature status, timestamps. Every field is structured metadata, not text pulled from a scanned image. Your team can build automations, trigger workflows, and route patients once the record is received.

FastPass starts with existing enrollment forms and transforms them into a structured, system-connected entry point. It enables data to be retrieved and received in coordination with covered entity workflows through the form itself, without requiring traditional system integration.

The enrollment data is mapped to FHIR-compatible fields based on the form data. This means the data captured during the enrollment workflow can be used for API-based integration with EHR systems, pharmacy platforms, and other FHIR-compatible healthcare infrastructure.