Skip Ribbon Commands
Skip to main content

Skip Navigation LinksResources-and-More-Information-About-Virtual-Visits

About Virtual Visits at St. Christopher's


St. Christopher's is closely monitoring the COVID-19 situation in our community.  As an alternative to in-person visits, we offer convenient virtual visit options for patients and their families, where clinically appropriate.  


Resources for your Virtual Visit


Below is a short collection of general forms used in the delivery of telehealth services.

Consent for Treatment


We ask that you read and sign the following Consent to Receive Treatment form.


Financial Responsibility


We ask that you read and sign the following Financial Responsibility form to acknowledge understanding of your patient financial responsibility.


Please complete the following verification form if you receive Medical Assistance.



Health Care Insurance Portability and Accountability Act (HIPAA)


We ask that you read and sign the following HIPPA form to acknowledge receipt of a Notice of Privacy Practices.


Health Information Exchange (HIE) 

A Secure Way to Share Your Medical Information with Other Health Care Providers and Hospitals Who Care for You


St Christopher’s participates in a Health Information Exchange (HIE). An HIE allows healthcare providers to appropriately access and securely share a patient’s medical information electronically across healthcare organizations. The benefits of an HIE include information sharing that allows for timely and efficient patient centered care and provides a more complete view of a patient’s health. 

What is the Health Information Exchange?
• Health information exchange is the electronic movement of health information between approved participating health care providers or health information organizations in a way that ensures the secure exchange of health information to provide care to patients.

Why is this Important?
• If your health care provider(s) participate in a Health Information Exchange their information about your health care, treatment, medication, and related information, will be more easily and more quickly shared with other health care providers. This helps your health care providers work together to make better-informed decisions about your health care.

• Health information exchange can improve the patient experience, reduce the unnecessary duplication of tests and procedures, improve health care results, and save money. 

How is my Health Information Protected?
• Health Information Exchange must follow all applicable federal and state privacy laws.

How do I Participate?
• You will automatically be enrolled to participate in the Health Information Exchange unless you choose to “opt-out”.
• I understand if I choose to “opt-out” that my choice will not affect my ability to receive medical care.
• I understand that my choice to “opt-out” of the Health Information Exchange will remain in effect until I change my choice in writing or by completing the Electronic Medical Record Network (Health Information Exchange) OPT-IN form.


How do I Opt-Out?

To opt out of sharing protected health information, please download an complete the following forms:


Explore all of St. Christoper's Hospital for Children  
© 2018 St. Christopher's Hospital for Children, All Rights Reserved