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What is a Personal Representative?

A personal representative is someone who participates in a patient’s healthcare —a parent, caretaker, etc.—  to help them manage their care and make decisions for them. When officially designated, personal representatives can access the patient’s Protected Health Information (PHI) such as test results, and request medical records.

You can designate or remove a personal representative by filling out one of the forms below.

Representation for Minors

Parents usually have full participation in their children’s healthcare. However, in situations where special rights protect a child’s medical information (e.g., rights regarding birth control and pregnancy), a minor may choose to make their parent or guardian a personal representative by signing a Designated Personal Representative (DPR) form.

When a patient reaches 18, the legal age of consent,  they can keep their parents as active representatives by signing another DPR. Otherwise, their medical information will become private.

Personal Representative vs. Health Care Agent

Personal representatives and health care agents both sign agreements to access medical information and make decisions for patients. However, the key difference is that health care agents may only do so when the patient cannot make their own decisions. For example, if they are unconscious or undergoing surgery, etc., making health care agents more common among elderly patients.

Designate or Remove your Personal Representative

To designate or remove your personal representative, please download the necessary forms below. Print, sign, and bring your completed form to your provider. You may also scan or digitally sign your form and email it to your provider.

Contact Us if you have any questions