Hixny Consent

Patient Consent

Patient Consent

A healthcare provider you recently contacted has asked for permission to access your electronic medical records through Hixny in order to provide you with medical care.

Providing an electronic signature will allow the provider to access your records from other providers you see.

What Is Hixny?

Hixny is a secure, nonprofit health information exchange that allows you and your healthcare providers to access your records electronically instead of requesting files by phone, fax, email or courier. Your providers may only access your records if you give them permission. Each of your providers who wants to use Hixny will ask your permission separately.

Select ”continue“ to confirm your identity and grant or deny your provider access to your records.

If you would like to provide consent at a later time, please contact your healthcare provider to request a new link.

Step 1: Confirm Your Identity

To start, please provide the information below to confirm your identity.

Please do not include:
  • Prefixes (Mr., Mrs., Dr., etc.)
  • Middle name or initial
  • Suffixes (Jr., Sr., etc.)

All form fields must be filled.

We're sorry. The information you entered does not match the information sent to Hixny by your provider. Please check that your name or the nickname you may have given your provider is spelled and capitalized correctly. Also check that your birth date is entered correctly. You have a total of 10 tries to match the data provided to Hixny. You have 9 tries left.

We're sorry. You have exceeded the maximum number of attempts to match these fields. Please contact Hixny Support at 518-640-0021, Option 2, for assistance.

Step 2: Grant or Deny Your Permission

Thank you for confirming your identity!

has requested permission to access your medical records through Hixny. If you consent (give your permission), will be able to see all of your medical information that is available through Hixny.

This session will end in 15 minutes.

Before signing your consent, you can:

Read the full Hixny consent form

Review important information and frequently asked questions

  • I understand that by typing my name and making a selection below, I am electronically signing my name to the Hixny consent form indicated above.

  • Do you grant permission to access to your medical records through Hixny?

Thank you, your consent response is saved. You have chosen to grant permission to access your medical records through Hixny. Please download a copy of your completed consent form for your records. If you would like to change your consent status for this provider at any time, contact Hixny at 518-640-0021, Option 2, to request a new link.

Thank you, your consent response is saved. You have chosen to deny permission to access your medical records through Hixny. will not be able to view your records through Hixny. Please download a copy of your completed consent form for your records. If you would like to change your consent status for this provider at any time, contact Hixny at 518-640-0021, Option 2, to request a new link. Please be aware that your provider can still request your records from other providers by phone, fax, email or courier.

Thank you. If you would like to provide consent at a later time, please contact your medical provider to request a new link.

For more information about who shares data through Hixny, to withdraw consent or to learn how Hixny protects your privacy, visit Hixny.org. If you are a person with a disability who needs assistance using this form, please contact us at 518-640-0021, Option 2.

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