EPICCARE LINK ELECTRONIC MEDICAL RECORD ACCESS AGREEMENTMedical Record Access Agreement • December 9th, 2022
This is a fillable PDF. Please type in all information on this cover sheet and the following addendum, except for the signature blank on the right side of Page 5. This requires an actual signature or official electronic signature of someone authorized to sign for your organization. Please email the completed cover sheet and signed addendum to the EpicCare Link administrator at EpicCareLink@kumc.edu.
EpicCare Link EMR Site Access Agreement Cover SheetMedical Record Access Agreement • August 21st, 2017
This cover sheet may contain confidential information belonging to the sender and may be used only for the purpose for which it was requested or intended. Further use or disclosure without additional patient authorization or as otherwise permitted by law is prohibited. Please notify the sender at the number above if you believe you have received this cover sheet in error. Thank you. The University of Kansas Health System.
