A pass-through system for your data.
Build functions to integrate with your core platform. Five Field Form provides a suite of simple and flexible API endpoints to manage your data
How It Works
Use the Five Field Form app to collect sample data out in the field, even without Wi-Fi or internet access. Record up to five custom fields of data and submit your entry. Your data will be encrypted upon submission.
Examples include: collection location, container type, sample label, or storage temperature.
The app sends the data to a project webpage, accessible from a desktop computer, where samples are encrypted and stored for up to 90 days with a paid account. Each sample collected is encrypted, and Five Field Form will provide a time stamp of all activity, so you can view data uploads from others in real time.
Five Field Form also includes an export feature with API automation, that way you can transfer your data easily to your own database or management system. Your data remains encrypted at all times, during rest and transit. Alternatively, you can export your data as a .csv or .json at any time from your admin account.
About Us
Why We Made
Five Field Form
We saw a need for improving business workflows and have better tracking of business activities that happen outside the office. Business owners and managers need the security of knowing that while their team is out collecting information, it is being done efficiently and accurately. Companies can eliminate the need for paper forms that might get lost or be unreadable, and instead, have a consistent way to gather vital data with or without network service on a mobile device. With Five Field Form, information can be collected and transferred faster for improved processing time and analysis, helping businesses run more cost-effectively.
Use Cases
Here are some examples of how Five Field Form can make projects easier for you and your team.
Environmental sample collection
You have been tasked to collect water samples from a local lake with no internet access. There are several locations around the lake to sample, and you have sets of tests you're required to perform on each water sample. Use the Five Field Form website to set up and organize the data.
Setup Field 1 as “Location”: this is a drop-down list of the specified locations at the lake. (e.g. upstream tributary, above dam, below dam, outlet stream, overflow reservoir.)
Field 2 is "Container": this is the label attached to the container which can be entered as free text or by scanning a bar-code.
Field 3 is "Criteria": this is a drop-down list of the tests you will need run on each sample.
Field 4 is "Note": this is a required note about the sample.
Field 5 is hidden.
Once the fields are setup, you download the Five Field Form app, login and update the form fields. You are now ready to go out into the field and collect samples. Even though there is no Wi-Fi or cell phone service at the lake, you can save as many samples as needed on your mobile device. Through Five Field Form each sample is tagged with the time it was collected so you can track how long the sample has been in its container. Once your internet access is restored, upload your saved samples from the app to the web server. The administrator in the lab will know what you have collected and can prepare reagents for testing. The admin exports the new sample list and can reconcile your delivery when it arrives.
Setup Field 1 as “Location”: this is a drop-down list of the specified locations at the lake. (e.g. upstream tributary, above dam, below dam, outlet stream, overflow reservoir.)
Field 2 is "Container": this is the label attached to the container which can be entered as free text or by scanning a bar-code.
Field 3 is "Criteria": this is a drop-down list of the tests you will need run on each sample.
Field 4 is "Note": this is a required note about the sample.
Field 5 is hidden.
Once the fields are setup, you download the Five Field Form app, login and update the form fields. You are now ready to go out into the field and collect samples. Even though there is no Wi-Fi or cell phone service at the lake, you can save as many samples as needed on your mobile device. Through Five Field Form each sample is tagged with the time it was collected so you can track how long the sample has been in its container. Once your internet access is restored, upload your saved samples from the app to the web server. The administrator in the lab will know what you have collected and can prepare reagents for testing. The admin exports the new sample list and can reconcile your delivery when it arrives.
Chain of Custody
Your business processes samples across several different locations. With the Five Field Form timestamp, you can quickly and easily track the chain of custody of materials through your pipeline using the mobile app.
Set up Field 1 as "Sample Label": use the free bar-code scan feature to scan the sample label.
Set up Field 2 as "Process Step": set up a drop-down list of events: Pick-up, Delivered, Process Initiated, Process Completed, Materials ready.
Field 3 is hidden.
Field 4 is hidden.
Field 5 is hidden.
The process manager adds all individuals involved in processing materials to the Five Field Form project. Users receive an email from Five Field Form so they can log in and setup a password. Each person installs Five Field Form on their mobile device and downloads the form fields. As each person moves materials through process, each step is accurately recorded.
Set up Field 1 as "Sample Label": use the free bar-code scan feature to scan the sample label.
Set up Field 2 as "Process Step": set up a drop-down list of events: Pick-up, Delivered, Process Initiated, Process Completed, Materials ready.
Field 3 is hidden.
Field 4 is hidden.
Field 5 is hidden.
The process manager adds all individuals involved in processing materials to the Five Field Form project. Users receive an email from Five Field Form so they can log in and setup a password. Each person installs Five Field Form on their mobile device and downloads the form fields. As each person moves materials through process, each step is accurately recorded.
Your coffee shop has a long queue of customers, but the computer application for recording sales is offline. In minutes, Five Field Form can quickly and temporarily record your sales data.
Set up Field 1 as "Item sold": this will be a drop-down list of the most commonly purchased items (include other as an option).
Field 2 is “Price”: this is a free text field to enter the dollar amount of the sale.
Field 3 is hidden.
Field 4 is hidden.
Field 5 is hidden.
The shop manager sets up a Five Field Form account and registers one email address. The manager downloads the Five Field Form app to a tablet and downloads the form fields. The barista uses the general account login to record sales on the tablet provided by the manager that can be handed off to each staff member who is responsible for handling cash. Sales are more easily and accurately recorded. The manager can monitor sale activities on the Five Field Form website while on hold with technical support of the failed application.
Set up Field 1 as "Item sold": this will be a drop-down list of the most commonly purchased items (include other as an option).
Field 2 is “Price”: this is a free text field to enter the dollar amount of the sale.
Field 3 is hidden.
Field 4 is hidden.
Field 5 is hidden.
The shop manager sets up a Five Field Form account and registers one email address. The manager downloads the Five Field Form app to a tablet and downloads the form fields. The barista uses the general account login to record sales on the tablet provided by the manager that can be handed off to each staff member who is responsible for handling cash. Sales are more easily and accurately recorded. The manager can monitor sale activities on the Five Field Form website while on hold with technical support of the failed application.
Remote Helper
You have an external collaborator that has agreed to collect nasal swabs for a clinical research study in a hospital clinic. Although the collaborator will not be given access to clinical trial database, this person can collect sample data via Five Field Form.
Set up Field 1 as "Sample Label": this is free text field, but since the collection swabs have been pre-labeled with bar code ID's, the user will use the bar-code scan feature
Field 2 is “Patient ID”: this will be a free text field and the user will scan a second bar-code of the patient study ID.
Field 3 is hidden.
Field 3 is hidden.
Field 3 is hidden.
Set up Field 1 as "Sample Label": this is free text field, but since the collection swabs have been pre-labeled with bar code ID's, the user will use the bar-code scan feature
Field 2 is “Patient ID”: this will be a free text field and the user will scan a second bar-code of the patient study ID.
Field 3 is hidden.
Field 3 is hidden.
Field 3 is hidden.
Instant Raffle
Your Rotary Club is running a raffle for a cash prize. Members of your group want to sell raffle tickets to friends and family that live far away. Use Five Field Form to organize and sell tickets without paper documentation. The Raffle administrator signs up with Five Field Form and subscribes for unlimited services.
Setup Field 1 as “Name”: this is the name of the raffle ticket purchaser.
Field 2 is “Email address”: the email of the purchaser will be used to confirm entry into the raffle.
Field 3 is “Phone number”: the ticket winner will be notified by phone.
Field 4 is “Payment”: how much was paid to the organization.
Field 5 is “Payment method”: drop down list of approved payment methods: Cash, Check, Venmo, Paypal.
The raffle administrator can set up member users in Five Field Form. Members receive an email from Five Field Form so they can log in and setup a password. Each person installs the Five Field Form on their mobile device and downloads the form fields. As each person sells tickets, the members upload their sales data to Five Field Form. The raffle administrator pulls the data from the Five Field Form webserver and emails the purchaser as confirmation of receipt of payment and their entry in the raffle. After the big winner is selected, discontinue the Five Field Form subscription until next year.
Setup Field 1 as “Name”: this is the name of the raffle ticket purchaser.
Field 2 is “Email address”: the email of the purchaser will be used to confirm entry into the raffle.
Field 3 is “Phone number”: the ticket winner will be notified by phone.
Field 4 is “Payment”: how much was paid to the organization.
Field 5 is “Payment method”: drop down list of approved payment methods: Cash, Check, Venmo, Paypal.
The raffle administrator can set up member users in Five Field Form. Members receive an email from Five Field Form so they can log in and setup a password. Each person installs the Five Field Form on their mobile device and downloads the form fields. As each person sells tickets, the members upload their sales data to Five Field Form. The raffle administrator pulls the data from the Five Field Form webserver and emails the purchaser as confirmation of receipt of payment and their entry in the raffle. After the big winner is selected, discontinue the Five Field Form subscription until next year.
Weekly equipment check
You've been tasked with overseeing weekly checks on equipment, and accurate documentation is required for regulatory compliance. The equipment is scattered around many areas of your company and multiple users are responsible for recording the equipment status. To maintain accurate logs, you decide to use Five Field Form.
You have four types of equipment to check.
Set up Field 1 as "Equipment Type": this is a drop-down with: "Eye wash station", "Refrigerator", "CO2 tank", and “Ultra-Low freezer”
Field 2 is "Location": this can be a free text field such as a room number or a specified equipment tag ID (bar-code)
Field 3 is "Status": this is a drop-down list. "Within specified range" or "Outside specified range"
Field 4 is "Value": this will be a free text entry to record the temperature, pressure, or activation.
Field 5 is hidden.
Add the email address of all users into your Five Field Form project. Each user will sign up, install the app on their mobile device, login, and download the form fields. Each user will enter weekly information for the equipment in their area. Because all information is now logged electronically via Five Field Form, you can view, download, and record the equipment status. If any item is out of range or requires maintenance, the issue can be identified and addressed immediately. Each record has the email address of the user who uploaded the information and is date and time stamped. Compliance is easily and accurately monitored.
You have four types of equipment to check.
Set up Field 1 as "Equipment Type": this is a drop-down with: "Eye wash station", "Refrigerator", "CO2 tank", and “Ultra-Low freezer”
Field 2 is "Location": this can be a free text field such as a room number or a specified equipment tag ID (bar-code)
Field 3 is "Status": this is a drop-down list. "Within specified range" or "Outside specified range"
Field 4 is "Value": this will be a free text entry to record the temperature, pressure, or activation.
Field 5 is hidden.
Add the email address of all users into your Five Field Form project. Each user will sign up, install the app on their mobile device, login, and download the form fields. Each user will enter weekly information for the equipment in their area. Because all information is now logged electronically via Five Field Form, you can view, download, and record the equipment status. If any item is out of range or requires maintenance, the issue can be identified and addressed immediately. Each record has the email address of the user who uploaded the information and is date and time stamped. Compliance is easily and accurately monitored.