Electronic signature Oregon Charity NDA Simple

When a client enters information (such as a password) into the online form on , the information is encrypted so the client cannot see it. An authorized representative for the client, called a "Doe Representative," must enter the information into the "Signature" field to complete the signature.

Yes. Please follow this link to download and fill-out the form. I am a new patient or patient on my last visit. Can I still use the electronic health record if I am already in my current hospital? Yes. Can I use my paper charts (I-95, etc) for this appointment? Yes, the patient record will not be removed, or converted, from a paper chart to an electronic chart. How can I view my charts on my computer, tablet or IPhone? On your computer, tablet, or Ipod, go to the "Patient" tab and look for the "Patient" column. The patient record is on it, and it should say "ePatient record" Can I use a paper chart at the computer? No, the patient record must be in PDF format. No printer, electronic inkjet, laser or fax is allowed. Can I have two copies of my chart at all times? Yes, the patient record must be on your own computer, tablet and Ipod screen. Does my patient record have a "date of service? " Yes, the date of service is listed on every record that you fill out. For a complete listing of date of service in your state, please click here What if my patient record gets destroyed? Contact the hospital and they will help to replace it. If there is a problem with the patient record, what will I be told? Contact your provider immediately to discuss the issue. The information that you provided must be accurate. Any changes to the information should be documented so that there is always a record to review. What if my patient's record gets stolen? Contact the hos...

I will be using the signer below (with my permission) to create your digital signature. I will need your email address and the address you want to use for receiving notifications. The email address you provide me MUST EXPORT AN EMAIL ADDRESS WITH A COMPANY NAME OR A PERSONAL NAME! I would like to receive your signature and I am willing to use the above link to have your email address added to a list of people who have created signatures for my project. You can change your mind later, after you get the email.