Your Medical History

Please answer the following questions

Current occupation:

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PHIA permits us to collect and use your personal health information. In certain circumstances, PHIA also allows us to share it with others both inside and outside our organization. We do this for purposes such as:
To provide you with health care; To get payment for your care which could include private insurers; To do health system planning and research; To report as required by law; Unless you tell us not to, we can share your personal health information with any health care provider who has, is or will be providing you with health care. Members of your health care team are only allowed access to the information they need to give you the care you need.

If you tell us not to share your information with a health care provider, we will not share your information unless permitted or required by law to do so. Please tell a member of your health care team if you do not want
your information shared with a health care provider.