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Terms and Conditions — My St. Luke’s Chart

St. Luke’s Healthcare offers secure viewing and communication as a service To patients who wish to view parts of their records and communicate with our staff and physicians. Secure messaging can be a valuable communications tool, but has certain risks. In order to manage these risks, we need to impose some conditions of participation.

This form is intended to show that you have been informed of these risks and the conditions of participation, and that you accept the risks and agree to the conditions of participation.

How the Secure Patient Portal Works

A secure web portal is a kind of webpage that uses encryption to keep unauthorized persons from reading communications, information or attachments. Secure messages and information can only be read by someone who knows the right password or passphrase to log in to the portal site. Because the connection channel between your computer and the website uses secure sockets layer technology, you can read or view information on your computer, but it is still encrypted in transmission between the website and your computer.

Protecting Your Private Health Information and Risks

This method of communication and viewing prevents unauthorized parties from being able to access or read messages while they are in transmission. No transmission system is perfect, and we will do our best to maintain electronic security. However, keeping messages secure depends on two additional factors: the secure message must reach the correct email address, and only the correct individual (or someone authorized by that individual) must be able to get access to it.

Only you can make sure these two factors are present. We need you to make sure we have your correct email address and that you inform us if it ever changes. You also need to keep track of who has access to your email account so that only you, or someone you authorize, can see the messages you receive from us.

If you pick up secure messages from a web site, you need to keep unauthorized individuals from discovering your password. If you think someone has discovered your password, you should promptly go to the web site and change it.

Patient Acknowledgement and Agreement

I acknowledge that I have read and fully understand this consent form and the Policies and Procedures Regarding the Patient Portal that appear at login. I understand the risks associated with online communications between my physician and me, and consent to the conditions outlined herein. In addition, I agree to follow the instructions set forth herein including the policies and procedures as set forth in the login screen, as well as any other instructions that my physician may communicate with patients via online communications. All of my questions have been answered, and I understand and concur with the information provided in the answers.

Authorization for Proxy Access

This form may be used to authorize proxy access to another person’s My St. Luke’s Chart account. The general requirements for proxy access to My St. Luke’s Chart account record are:

  • This Authorization for Proxy Access form must be completed with the appropriate information below provided and signed.
  • Each individual requesting proxy access to a patient’s My St. Luke’s Chart account record must have their own My St. Luke’s Chart account. If the individual requesting access does not have an account, St. Luke’s Healthcare will provide My St. Luke’s Chart activation email or letter with instructions on how to create one.

If the Patient is a Minor:

  • Proxy Designation. For minors under the age of 13, the parent/legal guardian may designate himself/herself to have proxy access and the parent/legal guardian may also designate any other adult to have proxy access. Individual requesting access as legal guardian must provide appropriate legal documentation of guardianship to St. Luke’s Healthcare.
  • Disclosure of Information. The parent/legal guardian understands that this will allow the person designated as proxy to have access to the minor’s My St. Luke’s Chart account including the medical and billing information contained in My St. Luke’s Chart. The parent/legal guardian authorizes the disclosure of this information to the proxy as described in the Authorization section below.
  • Revocation/Termination. Parent/legal guardian proxy access to a minor patient’s My St. Luke’s Chart account is revoked when:
    • Automatically when the minor patient turns 13 years old. (Continued access may be requested on a case by case basis by the minor’s provider/caregiver)
    • Parent/legal guardian submits a request to revoke proxy access.
    • Minor patient advises St. Luke’s Healthcare of his/her status as an emancipated minor.
    • Access disputes between parent/legal guardian and minor, or between parents, cannot be resolved.

If proxy access of a parent/legal guardian is revoked, the minor patient’s My St. Luke’s Chart account will be suspended/terminated (a minor may not have an independent account; parent/legal guardian is required). Access may also be terminated as provided in the Terms & Conditions.

Special Rules for Minors. Under state and federal law, there are certain types of medical information that a parent/legal guardian of a minor patient may not view without consent of the minor patient. Because the State of North Carolina does not designate a specific age for this access restriction, St. Luke’s Healthcare will use best efforts to exclude such confidential information from proxy access for all minors. This restriction will occur automatically upon the minor turning 13. Additionally, a minor over 13 years of age must authorize proxy access and disclosure of such confidential information contained in My St. Luke’s Chart to the parent/legal guardian.


The patient or patient’s representative/guardian/parent authorizes the disclosure of all medical and billing information about the patient contained in the patient’s My St. Luke’s Chart account to the person granted proxy access as designated below. The purpose of the authorized disclosure is to allow the person granted proxy access as designated below to be able to have on-going access to the medical and billing information in this patient portal to allow the proxy to participate in the medical care of the patient.

The patient or patient’s representative/guardian/parent understands that the person receiving proxy access is not a healthcare provider or health plan covered by federal privacy regulations, and the information accessed by the proxy could be re-disclosed by such person and will likely no longer be protected by the federal privacy regulations.

As described above patient or patient’s representative/guardian/parent understands that he/she may revoke this authorization in writing at any time, except to the extent that action has been taken by St. Luke’s Healthcare in reliance on this authorization, by sending a written revocation to the St. Luke’s Hospital Health Information Department or the St. Luke’s Healthcare location where you receive your medical care. This authorization will expire upon revocation by the patient or patient’s representative/guardian/parent, upon termination of the patient’s My St. Luke’s Chart account by St. Luke’s Healthcare, or as otherwise provided above.

The patient or patient’s representative/guardian/parent understands that he/she is not required to sign this authorization form and that St. Luke’s Healthcare will not condition the provision of treatment or payment on the signing of this authorization.

Additional Instructions and Agreement

Communications on behalf of the patient must be sent from, and responses will be received in, the patient’s My St. Luke’s Chart account record. My St. Luke’s Chart email alerts will be sent to the email address entered in the patient’s My St. Luke’s Chart account record.

When using proxy access to view another person’s My St. Luke’s Chart record, the proxy will log into his/her account and have access from his/her account to the other person’s My St. Luke’s Chart record. A visual indicator will appear to highlight that the proxy is accessing the My St. Luke’s Chart record of that person. If the proxy has access to multiple My St. Luke’s Chart records through proxy access, the proxy should verify that he/she is viewing the correct record.