Get the free Patient Portal Proxy Registration Form - Pediatric Affiliates, PA
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Patient Portal Proxy Registration Form
We are offering our patients the opportunity to join FollowMyHealth, a secure patient portal that will give you internet access to
summaries of your children
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What is patient portal proxy registration?
Patient portal proxy registration allows a designated individual to access and manage a patient's health information and online account on their behalf.
Who is required to file patient portal proxy registration?
Patients who want to grant access to a trusted individual, such as a family member or caregiver, to manage their health information through the patient portal.
How to fill out patient portal proxy registration?
To fill out patient portal proxy registration, the patient must provide their information and the information of the designated individual, along with a signed authorization form.
What is the purpose of patient portal proxy registration?
The purpose of patient portal proxy registration is to ensure that patients have control over who can access and manage their health information online.
What information must be reported on patient portal proxy registration?
Patient portal proxy registration typically requires the patient's name, contact information, and the designated individual's name and relationship to the patient.
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