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MyLifespan Teenager Sign-Up Form & Authorization

WebOptional Proxy Authorization for Release of Teenager Medical Information (To be completed by teenager who wants to allow a parent shared access to his or her MyLifespan …

Actived: Just Now

URL: https://my.lifespan.org/mychartprd/en-us/docs/TeenProxyConsentForm.pdf

MyLifespan Access Adult to Adult Form to Establish Proxy …

WebSection 2: Proxy’s Agreement to Follow MyLifespan Terms and Conditions. I understand that MyLifespan is intended as a secure online source of confidential medical information. If I …

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