EFTA00308055Set 9
11p3,765w
Patient (Parent/Guardian) Signature Date
EFTA00308059
, NYU Langone
Health
HEALTH INFORMATION EXCHANGE,
CARE EVERYWHERE AND HEALTHIX
CONSENT FORM
In this Consent Form, you can choose whether to allow the health care ... Hospitals Center to see and obtain access to your electronic health records through Healthix, which is a Health
Information Exchange, or Regional Health Information Organization (RHIO), a not-for-profit ... access your records from your other healthcare
providers authorized to disclose information through Healthix. A complete list of current Healthix Information Sources is
available from Healthix and can be obtained
https://www.justice.gov/epstein/files/DataSet%209/EFTA00308055.pdf