Permission and Consent
The form is asking for permission to access your private healthcare information.
[[Client Name of Application Requesting Permission]].
Protected Health Information (PHI)
You have the right to a copy of your protected health information (PHI) as maintained in the patient application programming interface (API). The information maintained in the patient API consists of/includes adjudicated claims, encounter data and clinical data.
Information disclosed to a third party is no longer protected by HIPAA Privacy Regulations. Information disclosed as a result of this consent may be re-disclosed by the recipient. Federal and state privacy laws may no longer protect your PHI.
In clicking below, you affirm that you are the individual who is the subject of the information requested and hereby consent to transferring/sharing a copy of your information to [[INSERT NAME OF APP]].