> ## Documentation Index
> Fetch the complete documentation index at: https://docs.altohealth.io/llms.txt
> Use this file to discover all available pages before exploring further.

# Supported File Formats

> File types supported by Alto Health's referral processing platform

## Overview

Alto Health accepts referrals and medical documents in multiple formats. Our AI platform processes unstructured documents from any source channel—email, fax, scanned documents, or direct upload.

## Supported Formats

### Image Formats

* **PNG** - Portable Network Graphics
* **JPEG/JPG** - Joint Photographic Experts Group

### PDF Documents

* **PDF** - Portable Document Format (including scanned PDFs)

### Spreadsheets

* **CSV** - Comma-Separated Values

### Text Documents

* **DOCX** - Microsoft Word (Office Open XML)
* **DOC** - Microsoft Word (Legacy Format)
* **TXT** - Plain Text Files

## Document Requirements

<AccordionGroup>
  <Accordion icon="file-image" title="Image Files">
    * Maximum file size: 25MB per document
    * Minimum resolution: 300 DPI recommended for OCR accuracy
    * Supported: Scanned documents, photos of referral letters
  </Accordion>

  <Accordion icon="file-pdf" title="PDF Documents">
    * Maximum file size: 25MB per document
    * Supports both native PDF and scanned PDF documents
    * Multi-page PDFs fully supported
  </Accordion>

  <Accordion icon="table" title="Spreadsheet Files">
    * Maximum file size: 10MB per file
    * CSV files with structured referral data
  </Accordion>

  <Accordion icon="file-lines" title="Text Documents">
    * Maximum file size: 10MB per file
    * Supports Microsoft Word documents (.docx, .doc)
    * Plain text files (.txt) with UTF-8 encoding
  </Accordion>
</AccordionGroup>

## Upload Methods

Alto Health supports multiple ingestion channels:

<CardGroup cols={2}>
  <Card title="API Upload" icon="code">
    Upload documents programmatically via our REST API using the **POST /api/v1/pub/records/document-upload** endpoint.
  </Card>

  <Card title="Email Integration" icon="envelope">
    Forward referrals directly to your clinic's dedicated Alto Health email address for automatic processing.
  </Card>

  <Card title="Drag & Drop" icon="upload">
    Upload documents manually through the Alto Health web interface with drag-and-drop support.
  </Card>

  <Card title="Fax Integration" icon="fax">
    Receive faxed referrals automatically through integrated fax-to-digital conversion.
  </Card>
</CardGroup>

## Best Practices

<Steps>
  <Step title="Use High-Quality Scans">
    For scanned documents, use 300 DPI or higher to ensure optimal OCR accuracy and data extraction.
  </Step>

  <Step title="Ensure Legibility">
    Verify that handwritten notes, stamps, and signatures are clearly visible before uploading.
  </Step>

  <Step title="Include All Pages">
    Upload complete referral documents with all pages, including attachments and supporting clinical information.
  </Step>

  <Step title="Use Native Formats When Possible">
    Native PDF or DOCX files provide better extraction accuracy than scanned images.
  </Step>
</Steps>

## Need Support for Other Formats?

If your clinic uses document formats not listed here, contact our support team:

<Card title="Request Format Support" icon="headset" href="mailto:xiao@altohealth.io">
  Email: [xiao@altohealth.io](mailto:xiao@altohealth.io)

  We evaluate format support requests based on clinical workflow needs and technical feasibility.
</Card>

## Next Steps

<CardGroup cols={2}>
  <Card title="Upload Documents" icon="upload" href="/api-reference/endpoint/document-upload">
    Learn how to upload referrals via API
  </Card>

  <Card title="Integration Guide" icon="rocket" href="/quickstart">
    Get started with your first integration
  </Card>

  <Card title="Error Handling" icon="triangle-exclamation" href="/guides/error-handling">
    Handle upload errors and validation issues
  </Card>
</CardGroup>