I am trying to create a jotform integrated with Stripe that would allow

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    randolph nunez
    Asked on October 21, 2021 at 11:29 AM

    I am trying to create a jotform integrated with Stripe that would allow up to put in the different amount of copays and deductibles owed for medical visit fees



    This is a re-post of a comment on How to Integrate Stripe with Your Form

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    Kat
    Answered on October 21, 2021 at 01:49 PM

    Hi there,

    Happy to help!

    We do have a payment integration with Stripe, but in order for me to guide you on how best to set this up, I'll need just a little more information.

    Do you require the form respondents to indicate the amount themselves, or will these amounts be preset?

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    drnunez12
    Answered on October 21, 2021 at 01:55 PM
    We want to present the amounts
    It will vary depending on co pay etc
    Sent from my iPhone
    ...
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    Kat
    Answered on October 21, 2021 at 04:04 PM

    Hi again,

    Thank you for your response!

    Please allow me a little time to investigate potential options and possibly present some different examples, and I will get back to you via this thread as soon as possible.

    Thank you in advance for your patience and understanding!

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    Kat
    Answered on October 21, 2021 at 06:43 PM

    Hi again,

    Thank you again for your patience as I tested some options for you.

    I have put together a very simply, straightforward demo form here (it is currently in Test Mode with the Stripe integration): https://form.jotform.com/212936926335058

    First, I have a dropdown where the respondent can indicate which Co-Pay they are utilizing (for the purposes of my example, I have named them simply):

    1634855736_6171eb385f59b_

    Next, I've added a Form Calculation Widget and hidden it:

    1634855809_6171eb810624d_

    Then I added the Stripe integration, and set it to User Defined Amount under Payment Type, also indicating that the amount would come from our Form Calculation field (this is important so that the amount cannot be modified):

    1634855865_6171ebb939097_

    Next, we're going to set our conditions to change the amount in the Form Calculation field depending on which Co-Pay they select:

    1634856013_6171ec4d19282_

    1634856046_6171ec6e0b06f_

    We would repeat the same condition for each Co-Pay, except we would change the amount dependent on the co-pay. Your conditions would look like this when complete:

    1634856102_6171eca64181b_

    Now, the form works like this:

    1634856166_6171ece630e23_stripecopay.gif

    Would this be a viable for you?