Digital Health Declaration Form

🚧 Work in progress. Live demo: sagi-insurance.vercel.app

A mobile-friendly digital version of an insurance agency's adult health declaration form (Hebrew, right to left). It replaces paper forms:

1. The applicant fills in the form on their phone or computer and signs on screen.
2. They see a success screen and can download a PDF copy of the completed form.
3. The agent automatically receives the signed form as a PDF by email.

How it works

• Front end: HTML, CSS and JavaScript with input validation and a canvas signature pad. html2canvas and jsPDF turn the filled form into a PDF in the browser.
• Back end: a Vercel serverless function (api/send-form.js) receives the PDF and emails it with Nodemailer. Credentials are kept in environment variables, never in the code.

Tech stack

JavaScript · html2canvas · jsPDF · Node.js · Nodemailer · Vercel serverless functions