I attest that the login information I have entered is unique to me as an authorized user for my practice/employer; no other persons are authorized to use my login information to access protected health information hosted on this website; I am responsible for all activity that occurs while logged into this website.

I understand I am authorized to view, access, and use only the protected health information of those individuals who are patients of my practice/employer and which is necessary for me to perform certain job duties as permitted by the Privacy Rule of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) (45 C.F.R. 164.500 et. seq.). I agree to not request or view any protected health information I am not authorized to view, access, or use. My failure to abide by this declaration may result in civil and criminal penalties against me and my practice/employer.