1. Get started by clicking the "Get Records" button.
2. Click on the Add Provider button.
3. Using the search bar begin typing the name of the clinic you would like to request records from.
4. A list of possible results will appear. Choose the result which matches the information you have on the healthcare provider you would like to request records from.
5. Please confirm the provider details by clicking on the "Request" Button, if you see the information is incorrect you can click on the "Something looks wrong? Click here to suggest an edit" button to make any updates before submission.
6. Fill out the request form with all the information pertaining to your request. You can request all records pertaining to your visits or select specific records. You can also add any specific notes/messages you want to be forwarded to the provider regarding the request in the notes box at the bottom of the page. Once you have entered in all of the requested information please click the "Confirm Request button".
7. Review your order and sign the authorization. This authorization allows us to retrieve records on your behalf. Start the process by clicking the glowing "signature" icon.
8. Some clinics will require you to have a witness signature for your authorization. You can do this electronically by entering a friend or family members email and name. Please Do Not enter in your own name/email.
If an incorrect email address is entered for the witness, you will have the option to edit the witness information and resend the signature request to the correct email address.
9. Continue by clicking the Next button and follow the DocuSign signing process.
At the bottom of the authorization form, click the Sign icon. Your signature will then appear on the document. Once the signature has been added, click Submit Signed Consent to complete this step.
If you need to return to the previous screen, click Go Back. If you need to remove and re-enter your signature, select the Reset Signature option before submitting.
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10. You will not be able to complete you request until your witness completes the signing process if required. Once the witness signature has been completed click "Go to Checkout" and review the order. You will need to enter your credit card details to pay for the request submission. Click "Submit" to finalize the request.
Congratulations! You will receive your request as soon as possible.