EVERYTHING is in a doc or pdf. it is very common practice to electronically sign documents, even to docs and government... Everybody will set appointments against an electronic sig, and if they need a real sig, they will tag the file and get it from me when I show up in person.
In this entire massive medical thing I am doing, I pre-filled every form in PDF with an electronic sig, and sent it by email... When I show, there's a brief signing ritual and off we go.
I really do mean it. I can't remember the last time I printed anything. And nearly can't remember the last time I needed to.