The medical groups, hospitals, and other healthcare-related entities (Participants) who care for you and related parties who pay for such healthcare services share your health information through KONZA, a secure, electronic Health Information Exchange (HIE)* unless you Opt-Out of KONZA.
If you do not want your health information shared and used through the HIE, complete and submit the form below. By submitting this completed Opt-Out Form you understand and agree that: