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Get Epic Ehr Consent Form Page 1 Of 2 - Nyu Langone Medical Center
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How to fill out the Epic EHR Consent Form Page 1 Of 2 - NYU Langone Medical Center online
Filling out the Epic EHR Consent Form is an essential step in granting permission for the use of your electronic health information. This guide provides a clear and structured approach to completing Page 1 of 2 effectively and accurately.
Follow the steps to fill out the Epic EHR Consent Form online.
- Click the ‘Get Form’ button to obtain the form and open it in the editor.
- Read the introductory information provided in the form, which outlines the purpose of the consent and how your health information will be utilized.
- In the section indicating receipt of the fact sheet, check the box confirming that you have received and understood the consent document.
- Fill in your name and signature in the space provided, as well as the date you are signing the form.
- Indicate the time of day in which you are signing the form, selecting either AM or PM as appropriate.
- If the consenting party is not the patient, write the full name and relationship to the patient in the designated area.
- Once all fields are completed, review the form for accuracy and clarity.
- After finalizing your entries, you can save changes, download the form for your records, print it out, or share it as needed.
Complete your forms online for a streamlined healthcare experience.
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I do hereby attest that this information is true, accurate and complete to the best of my knowledge and I understand that any falsification, omission, or concealment of material fact may subject me to administrative, civil, or criminal liability.”
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