Consent Forms

Consent Forms

Please review and sign the required consent forms to continue using MyHealth Ally.

Important: MyHealthAlly is a health navigation and concierge platform. Medical services are provided by independent, licensed practices.

HIPAA Authorization and Consent

Required

Not Signed

Telehealth Services Consent

Required

Not Signed

Financial Responsibility and Payment Authorization

Required

Not Signed

Consent for Treatment

Required

Not Signed