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PALOS HOSPITAL / PALOS MEDICAL GROUP PATIENT …

WebHealth Information Management Palos Hospital 12251 S 80th Avenue Palos Heights, IL 60463. You may also file a complaint by contacting PH Patient Advocate Line at 708-923 …

Actived: 8 days ago

URL: https://mychart.paloshealth.com/MyChart/P-316_Patient_Request_for_Amendment_Protected_Health_Information.pdf

Learn More About Bringing Your Health Information Together

WebAs you move between your healthcare providers, this organization may securely exchange your health information with other healthcare organizations so that your care team can …

Category:  Health Go Health

Minor Proxy Authorization (under age 12)

WebSignature of Parent/Guardian* Relationship to Patient Date (Required) Palos MyChart Patient Portal - Minor Proxy Authorization (under age 12)

Category:  Health Go Health

mychart.paloshealth.com

WebPalos MyChart Patient Portal. Minor Proxy Authorization (under age 12) This form must be completed to provide the parent(s) or legal guardian(s) ac. cess to the P. alos MyChart

Category:  Health Go Health

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