Form not submitting data

Hello. This form apparently stopped accepting submissions on Feb 24:

https://hipaa.jotform.com/210455568613053

Please advise asap - I cannot see any errors or any feedback that there is an issue with the form.

I tested your form and was able to submit it successfully.

Can you please check your Submissions page and confirm that you can see my test submission?

We will wait for your response.