Patient Contacts Form Copied

Step 1: Updated Emergency Contact page to include:

• Prepopulated information based on the emergency contact information already captured in your Practice Management System (PMS).
• If there is no emergency contact information for this patient in your PMS, then the patient must manually complete the form.
• All required fields for 1st Emergency Contact must be completed before proceeding (callouts 1-4).
• Adding a 2nd Emergency Contact is optional; however, if another contact is added then the First Name, Last Name, Phone Number, and Relationship fields must be completed before proceeding.

Step 2:

• Display an Authorization to Release Information.
• Automatically select the option to grant permission to release information to an emergency contact (callout 5).
• One contact must be selected to proceed (callout 6).
• Patients may also choose to decline authorization (callout 7).

Step 3: Consent statements updated to include:

• Consenting patients acknowledge that their information may be shared with their emergency contact(s) until they revoke the authorization (see example below).
• Declining patients acknowledge their decision to decline consent.