We require your explicit consent to retrieve any of your data for you, so you'll sign a consent form for each institution request you make. We only provide your health care provider the information they require to release your records. 

The following information is what we require on the authorization form:

Your information:

  • Full name
  • Health card number
  • Date of birth
  • Address¬†
  • Phone number
  • Email address
  • Signature

Health institution's information:

  • Institution name
  • Address

Although all of your information is pre-filled from your profile on the consent form, we require an original signature to confirm that you would like Dot Health to collect and post your records in your profile. We will never send out a request without your original signature and authorization.

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