If you have previously chosen not to participate and have opted out, and now you want your caregivers to share your medical information using HealthInfoNet, you'll need to opt-in. To opt-in, fill out the form below, or contact HealthInfoNet at 866-592-4352, 207-541-9250 or firstname.lastname@example.org.
If you would prefer to download and print a paper opt-in form to mail or fax, click here.
I Choose to Participate and Opt-In
We will not share, sell, or release your information to anyone. Your email address will be used to generate a confirmation email that you may save for your records. Access to your email information is restricted to HealthInfoNet employees authorized to manage the information system used to generate electronic opt out/in confirmation email messages.