In many health care specialties, there is a need to collect detailed self-report survey information from a patient in order to properly diagnose and treat that patient's medical condition. Despite the great advances that have been made in IT systems within the MHS, the current systems are not set up to provide a convenient way to collect this information from patients and insert it into the electronic health care record. Indeed, in most cases, medical survey information still collected using pencil and paper surveys that are mailed to patients or filled out in the waiting room, hand scored by providers, and either disposed of or scanned into a medical record in a non-searchable pdf format. Although it seems like it would be trivially easy to allow patients to use a web-based application or tablet PC to enter self-reported survey information directly into the medical record, this actually turns out to be incredibly complex and expensive because it cannot be achieved without providing the patient with unsupervised access to a computer system that contains highly sensitive HIPPA data. This submission describes a low-cost system we have developed at the Audiology and Speech Center at Walter Reed that allows patients to fill out complicated surveys either at home or on their smartphones and allows providers to access this data and upload it into the electronic medical record without providing the patient direct access to the hospital IT system or placing the patient's personally identifiable information at risk. We believe the method has wide applicability across all medical specialties throughout the MHS, and that it has the potential to decrease costs and improve health care quality and the overall experience of MHS patients.