Authorization and Purpose. I authorize or give permission for the Organization named below, and its physicians/staff as deemed appropriate to view/access my medical records stored electronically at the University of Michigan Hospitals & Health Centers (UMHHC) for the purpose of my continued medical treatment I understand that I am not required to sign this authorization, and both the UMHHC and the Organization named below will not condition treatment, payment, enrollment or eligibility for benefits on whether I sign this document.
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Sources: Umhs Electronic Health Information Access Agreement, Umhs Electronic Health Information Access Agreement
Authorization and Purpose. I authorize or give permission for the Organization named below, and its physicians/staff as deemed appropriate to view/access my medical records stored electronically at the University of Michigan Hospitals & Health Centers (UMHHC) for the purpose of my continued medical treatment treatment. I understand that I am not required to sign this authorization, and both the UMHHC and the Organization named below will not condition treatment, payment, enrollment or eligibility for benefits on whether I sign this document.
Appears in 1 contract