Consent for Email / Text Message Communication of Patient Health Information
As a health care provider, providing access to your records in a secure manner while balancing ease of access is important to us. If you have requested that we transmit a copy of your records, which may contain your Protected Health Information (PHI), via email or text message, we are required by law to notify you that email/text is not a completely secure means of communication due to the fact that messages can be addressed to the wrong person or messages can be intercepted during transmission by a third party.
If you acknowledge the above risks and still would like for us to send your information via email/text message, please print clearly, sign and complete the consent below. Please note – due to some email providers, certain size files may not be transmitted. In the event that there is trouble with transmission, we will mail a copy of your records to your home address.