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Prisma Health Patient Portal Agreement


This account is for the patient. For parents/legal guardians of patients under 16 years of age, the parent should have a proxy account along with the account of the patient. The proxy account can be set up at the next office visit.

In consideration of participation, I understand and agree to the following:


I. Use of the Patient Portal

  1. I understand that anyone I share my Patient Portal user name and password with will be able to see my confidential medical record information. Prisma Health will not have responsibility for breach of my confidential information due to my sharing or losing my user name and password.
  2. I will select a password and maintain it in a secure manner. If I ever believe that my password is not secure, I will change it by following the procedures in the Patient Portal.
  3. I will not use the Patient Portal in an emergency. In that case, I will seek emergency care.
  4. I will use the Patient Portal only as permitted in this Agreement.
  5. The Patient Portal is being provided as a convenience. Prisma Health may terminate my access at any time for any reason, including if Prisma Health determines it is not in my best interest to have access.
  6. The Patient Portal does not give access to my complete medical record.

II. Provision of Services

  1. There is no charge for the Patient Portal.
  2. Prisma Health will try to keep the Patient Portal free from error, but cannot guarantee the completeness, accuracy, or adequacy of the information. Prisma Health does not guarantee that the Patient Portal will be fault-free, but Prisma Health will attempt to correct reported problems in a reasonable period of time. If I believe that my information is not accurate, I will contact my Prisma Healthysician's office immediately.

III. Privacy

  1. A copy of the HIPAA Notice of Privacy Practices can be found online or at any Prisma Health location.
  2. Prisma Health may use Patient Portal data without further authorization from me for Prisma Health educational activities and programs, and for research purposes so long as the information is de-identified and used in accordance with state and federal regulations.

IV. Security

The Patient Portal is protected using industry standard security measures. If I have concerns, I may decide to terminate my account.

V. Disclaimer

I understand and agree to the following:

  1. Prisma Health takes no responsibility for and disclaims any and all liability arising from any inaccuracies or defects in the information, software, communication lines, internet or my internet service provider, computer hardware or software, or any other service or device that I may use to access the Patient Portal.
  2. My medical information, including but not limited to information regarding substance abuse, pregnancy and treatment, testing and diagnosis of sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV), may be published to the Patient Portal.
  3. This Agreement is in effect for all Prisma Health providers and all locations or until such time that I choose to terminate this Agreement. In order to terminate this Agreement and my access to the Patient Portal, I will go to a Prisma Health practice or facility and complete termination documentation.
  4. Prisma Health may modify these terms and conditions, other terms and materials referenced in this document, the Patient Portal, or the content of the Patient Portal website at any time.
  5. The Patient Portal is provided solely for my personal use. Republication, distribution, or use of the Patient Portal inconsistent with the terms and conditions described is strictly prohibited.

This Agreement will be governed in accordance with the laws of the State of South Carolina.

For Patient Access

I attest that I have read and assent to these terms and conditions and I am fully aware of and understand that if it is found that I have misrepresented myself, my access to the Patient Portal may be terminated and Prisma Health may pursue other legal remedies available. If I am between the ages of 12-15, I understand that my parent/legal guardian will have access to my health information. I agree to protect the healthcare information of the patient through all reasonable measures.

For Parent/Legal Guardian

I hereby attest that I am the parent and/or legal guardian of the patient, and do hereby attest that I have read the above information. I further attest that I have the authority to agree to these terms and conditions and I am fully aware of and understand that if it is found that I have misrepresented myself, my access to the Patient Portal may be terminated and Prisma Health may pursue other legal remedies available. I agree to protect the healthcare information of the patient through all reasonable measures.

I further attest that access to the patient's medical records on the Patient Portal has been granted to me by the patient, if the patient is between the ages of 12-15. I further attest that I have read and assent to the terms and conditions of the Patient Portal.





Self Regional Patient Portal Agreement


This account is for the patient. For parents/legal guardians of patients under 16 years of age, the parent should have a proxy account along with the account of the patient. The proxy account can be set up at the next office visit.

In consideration of participation, I understand and agree to the following:


I. Use of the Patient Portal

a. I understand that anyone I share my Patient Portal user name and password with will be able to see my confidential medical record information. Self Regional Healthcare and SRH Partners in Health, Inc. (SRH)

will not have responsibility for breach of my confidential information due to my sharing or losing my user name and password.

b. I will select a password and maintain it in a secure manner. If I ever believe that my password is not secure, I will change it by following the procedures in the Patient Portal.

c. I will not use the Patient Portal in an emergency. In that case, I will seek emergency care.

d. I will use the Patient Portal only as permitted in this Agreement.

e. The Patient Portal is being provided as a convenience. SRH may terminate my access at any time for any reason, including if SRH determines it is not in my best interest to have access.

f. The Patient Portal does not give access to my complete medical record.


II. Provision of Services

a. There is no charge for the Patient Portal.

b. SRH will try to keep the Patient Portal free from error, but cannot guarantee the completeness, accuracy, or adequacy of the information. SRH does not guarantee that the Patient Portal will be fault-free, but SRH will attempt to correct reported problems in a reasonable period of time. If I believe that my information is not accurate, I will contact my Prisma Healthysician’s office immediately.


III. Privacy

a. A copy of the HIPAA Notice of Privacy Practices can be found at any SRH location, or online at http://www.selfregional.org/notice-of-privacy-practices/.

b. SRH may use Patient Portal data without further authorization from me for SRH educational activities and programs, and for research purposes so long as the information is de-identified and used in accordance with state and federal regulations.


IV. Security

The Patient Portal is protected using industry standard security measures. If I have concerns, I may decide to terminate my account.


V. Disclaimer


I understand and agree to the following:

a. SRH takes no responsibility for and disclaims any and all liability arising from any inaccuracies or defects in the information, software, communication lines, internet or my internet service provider, computer hardware or software, or any other service or device that I may use to access the Patient Portal.

b. My medical information, including but not limited to information regarding substance abuse, pregnancy and treatment, testing and diagnosis of sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV), may be published to the Patient Portal.

c. This Agreement is in effect for all SRH providers and all locations or until such time that I choose to terminate this Agreement. In order to terminate this Agreement and my access to the Patient Portal, I will go to a SRH practice or facility and complete termination documentation.

d. SRH may modify these terms and conditions, other terms and materials referenced in this document, the Patient Portal, or the content of the Patient Portal website at any time.

e. The Patient Portal is provided solely for my personal use. Republication, distribution, or use of the Patient Portal inconsistent with the terms and conditions described is strictly prohibited.

This Agreement will be governed in accordance with the laws of the State of South Carolina.

For Patient Access

I attest that I have read and assent to these terms and conditions and I am fully aware of and understand that if it is found that I have misrepresented myself, my access to the Patient Portal may be
terminated and SRH may pursue other legal remedies available. If I am under the age of 16, I understand that my parent/legal guardian will have access to my health information. I agree to protect the healthcare information of the patient through all reasonable measures. For Parent/Legal Guardian Access I hereby attest that I am the parent and/or legal guardian of the patient, and do hereby attest that I have read the above information. I further attest that I have the authority to agree to these terms and conditions and I am fully aware of and understand that if it is found that I have misrepresented myself, my access to the Patient Portal may be terminated and SRH may pursue other legal remedies available. I agree to protect the healthcare information of the patient through all reasonable measures. I further attest that access to the patient's medical records on the Patient Portal has been granted to me by the patient, if the patient is under the age of 16. I further attest that I have read and assent to the terms and conditions of the Patient Portal.

Use of Third-Party Services

You may choose to use other services provided by third parties in conjunction with your use of MyChart. Such services may include, but are not limited to, translation services, location services, and other third-party offerings. Any links to such services are provided for your convenience only. Neither Epic nor Prisma Health have control over the contents of these services, and neither Epic nor Prisma Health or SRH accept any responsibility for them or for any loss or damage that may arise from your use of them. Such services may require you to submit your information to a third party, which may result in a copy of your information being used and/or stored by a third party. If you decide to access any such services in conjunction with your use of MyChart, you do so entirely at your own risk and subject to the terms and conditions of use for such services.