Email Authorization Form for Patient Communication

Habif Health and Wellness Center prefers to use the Student Portal for communications. This is the best way to communicate electronically. Please access the Student Portal to ensure your communication is private.

Electronic mail communication is available between you, your family (with your consent) and your providers. This form of communication in unencrypted format is not a secure communication and could be available for others to read. Habif Center has the ability to use encrypted email communication for personal health information. Encryption makes this information unreadable to anyone without the password to decrypt the message. You may use this consent form if you prefer unencrypted email communication over the patient portal.

Email authorization form (PDF)