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Carillon Clinic HIE Opt-out Request Form
This form is to be completed by patients who do not wish to have Carillon Clinic share
their health information with any Health Information Exchange (HIE).
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How to fill out carilion clinic hie opt-out
How to fill out carilion clinic hie opt-out:
01
Visit the official website of Carilion Clinic or contact their customer service department to request an opt-out form.
02
Fill in your personal information accurately, including your full name, address, email address, and contact number.
03
Provide specific details about your request, such as stating that you want to opt-out of the Carilion Clinic Health Information Exchange (HIE) program.
04
Sign and date the opt-out form to ensure its validity.
05
Submit the completed form to the appropriate department or address mentioned on the form.
06
Keep a copy of the form for your records.
Who needs carilion clinic hie opt-out:
01
Patients who do not want their medical information shared through the Carilion Clinic Health Information Exchange.
02
Individuals who prefer not to participate in the electronic sharing of their health records with other healthcare providers within the Carilion Clinic network.
03
Patients who have concerns about the privacy and security of their medical data and wish to maintain strict control over its accessibility.
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