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By, registering to the patient portal I am consenting to Marana Health Center's use and disclosure of my Protected Health Care Information, including information related to psychiatric care, drug and alcohol abuse, HIV/AIDS, and use of e-prescribing to obtain my medication history, for the purpose of carrying out treatment, payment and healthcare operations. I have been provided or offered a copy of Marana Health Center Privacy Statement.

I assign all medical and/or surgical benefits including major medical benefits to Marana Health Center for services rendered. By signing this form I am confirming that the above demographic and insurance information is current and correct.  If the information is not correct I understand I will be held responsible for all charges incurred in today's visit.

Marana Health Center and its affiliates, suppliers, and other third parties mentioned on this site are neither responsible nor liable for any direct, indirect, incidental, consequential, special, exemplary, punitive, or other damages (including, without limitation, those resulting from lost profits, lost data, or business interruption) arising out of or relating in any way to the site, site-related services and products, content or information contained within the "site," and/or any hyperlinked web site, whether based on warranty, contract, tort, or any other legal theory and whether or not advised of the possibility of such damages. Your sole remedy for dissatisfaction with the site, site-related services, and/or hyperlinked web sites is to stop using the site and/or those services. Applicable law may not allow the exclusion or limitation of incidental or consequential damages, so the above limitation or exclusion may not apply to you. 

By accepting MHC Healthcare Patient Portal registration terms, Patient Portal users agree to MHC Healthcare Acceptable Use policy. MHC Healthcare Acceptable Use policy prohibits use of offensive, inappropriate, abusive, or threatening language.