NOTICE AND DISCLOSURE

Parkview Health System, Inc. (Parkview Health) is pleased to offer our patients on line computer access to portions of their medical record through the MyChart web portal. You may sign up for access when you visit your Parkview Physicians Group office or by calling your Parkview Physicians Group office to discuss MyChart; requesting your unique activation code; and agreeing to the terms and conditions of use.

Parkview Health is the owner of this MyChart site.

MyChart and/or physician-patient email should NEVER be used for emergencies or urgent health care matters. If you believe you are experiencing an emergency or urgent or life threatening health condition, either phone your physician, go directly to the Emergency Department of a local hospital, or call 911.

At this time, MyChart will provide the following services:

• Ability to request appointments, cancel appointments with 24 hours advance notice, view past appointments and view upcoming appointments;
• Ability to view selected portions of my medical record such as allergies, medications, immunizations, medical history, health summary, current health issues and recent visit information;
• Access to selected test results;
• Electronic communication with my physician via secure messaging regarding health concerns, such as: non-urgent medical questions, prescription questions, test results questions, visit follow-up questions, referral requests and preventive care reminders;
• Requests for certain prescription refills;
• Financial account information; and
• Links to other sites that may provide me information on health topics.

The hours of operation during which Parkview Health staff will monitor and respond to MyChart messages are 8:00 AM to 4:00 on business days (not weekends or holidays). The anticipated turnaround time for a response to a MyChart message is by the end of the next business day. If your physician is out of the office or unavailable to respond to your MyChart message, your message may be routed to another Parkview Health provider. Lab results will be on MyChart within 4 days of being available to the physician office. Other services may be added as Parkview Health develops the MyChart web portal.

MyChart may not be used for:

• Same day appointment requests;
• Same day prescription refill requests;
• On-line clinical consultations and treatments; or
• Any purpose at all if your last office visit with your Parkview Health provider was more than one year ago.

These will require a telephone call, and possibly an office visit, to Parkview Health. MyChart is not available to patients under the age of eighteen (18) unless they are legally emancipated or otherwise able to consent to their own healthcare under.

MyChart is a part of Parkview Health. You may contact us at:

Parkview Health
Health Information Management
Attention MyChart
2200 Randallia Drive
Fort Wayne, IN 46805
Telephone: (855) 853-0001

The contact information for all of our physicians and office locations is available through the following link: http://www.parkviewtotalhealth.com/SignatureCare/sigcaremembers/providerdirectory/Pages/ProviderDirectory.aspx.

A link to the information about your particular physician office is available through MyChart when you are logged it.

All of our physicians and other healthcare professional are licensed and appropriately board certified for the type of care they provide in the states in which they provide care.

There is no charge for use of MyChart.

Both Federal and State laws govern the confidentiality of medical information. Parkview Health is dedicated to keeping your medical information confidential. Please read (Organizations) Notice of Privacy Practices for more information about how Parkview Health may use and disclose information. It also describes your rights with respect to patient health information. The Notice of Privacy Practices is available by clicking this link: http://www.parkview.com/PatientsVisitors/PatientResourcesForms/Pages/HIPAAPrivacyPractices.aspx. Except as provided in the Notice of Privacy Practices, Parkview Health will obtain your consent to forward patient-identifiable information to a third party.

We collect and track information about the use of MyChart in order to improve the site and our service to patients.

You may provide us feedback regarding MyChart and the quality of our information and services by using the Ask Customer Service feature of the Message Center.

If you have any complaints about MyChart you may let us know by also using the Ask Customer Service feature of the Message Center. You may also file any complaint you may have with the Consumer Protection Division of the office of the Attorney General of your state.

Individuals may request proxy access to a minors (under the age of eighteen (18) and unable to consent for their own care) MyChart account by completing a MyChart Proxy Access Authorization Form and submitting it to Parkview Health. Such access will only be granted to parties with parental rights or legal guardianship over the MyChart account holder and only to the extent that the party requesting proxy access can demonstrate the legal right to the account holder's medical information.

Individuals may also be granted proxy access to another adults MyChart account. The other adult or the other adults legal representative must complete the MyChart Proxy Access Authorization Form and submit it to Parkview Health.

A MyChart account will be activated for the proxy and the account holder. If you wish to create proxy access, call Parkview Health Release of Information at the following toll free telephone number: (855) 853-0001. If the proxys legal relationship with the account holder changes, the proxy must inform Parkview Health immediately by calling Parkview Health Release of Information at the following toll free telephone number: (855) 853-0001, or by sending written notice to Parkview Health, Health Information Management, Attention MyChart, 2200 Randallia Drive, Fort Wayne, IN 46805.

Parkview Health reserves the right to revoke proxy access at any time for any reason.

MyChart is a registered trademark of Epic Corporation