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Attestation of Treatment, Payment, or Healthcare Operations (TPO) or Public Health Reporting Purpose for Accessing Patient Records

By clicking ‘ACCEPT’ below, I agree to the terms of HIE participation and understand that HIPAA regulations apply to use of information in the etHIN system. I confirm that my access of any medical information through etHIN is solely for Treatment, Payment, or Healthcare Operations (TPO) purposes related specifically to a patient who is being treated by me or my Participating Provider, or the information is being used for Public Health reporting purposes by an employee of a Public Health reporting agency.
I UNDERSTAND AND AGREE THAT I AM NOT ALLOWED TO ACCESS MY PERSONAL HEALTH RECORDS NOR THOSE OF MY FAMILY, FRIENDS, COLLEAGUES, OR ANYONE OF PUBLIC INTEREST WITH WHOM I DO NOT HAVE A TPO RELATIONSHIP OR A PUBLIC HEALTH REPORTING AGENCY PURPOSE FOR INFORMATION.
I UNDERSTAND AND AGREE THAT ACCESSING THE INFORMATION OF THE PERSONS MENTIONED IN THE PREVIOUS PARAGRAPH FOR OTHER THAN A TPO OR PUBLIC HEALTH REPORTING AGENCY PURPOSE IS A VIOLATION OF ETHIN POLICY AND THAT I CAN PERMANENTLY LOSE MY ETHIN ACCESS IF I VIOLATE ETHIN POLICIES.