Disclosure Directive Forms

Adult Disclosure Directive Form ^{(PDF 607K)} this form is for individuals 19 years of age or older who want to apply or revoke a disclosure directive to laboratory data within their Electronic Health Record.

Parent on Behalf of Child Disclosure Directive Form ^{(PDF 610K)} this form is for a parent or guardian on behalf of their children. A parent or guardian must complete a separate form for each child to apply or revoke a disclosure directive to laboratory data within their Electronic Health Record.

Minor Disclosure Directive Form ^{(PDF 608K)} this form is for individuals 18 years of age or under. A minor must be able to demonstrate that he or she understands the nature and consequences of making a disclosure directive, to make or revoke a disclosure directive for him or herself.

Guardian on Behalf of Adult Disclosure Directive Form ^{(PDF 614K)} this form is to be completed by a guardian making or revoking a disclosure directive on behalf of another adult.

eHealth will provide

secure and authorized access to health records from anywhere in the province
physicians better access to patient records
consolidated lab results - your tests online for your caregiver when you need them
enhanced PharmaNet improved patient safety
X-rays, CT scans and MRIs online for your caregiver
health services over distance - TeleHealth, in rural and remote areas and for First Nations
improved public health service delivery to the public

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Disclosure Directive Forms

eHealth will provide