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Medline

  • SNF
  • LPC
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Measure up to the challenges of improving care, increasing accuracy and saving precious nursing time with CareConnection. Vitals and weights wirelessly transmit immediately and error-free from bedside to your resident’s chart, speeding alerts to trigger rapid care plan intervention. Empower your team to prevent hospital readmissions with SMART*Reports that are early indicators of resident health crisis. Let us help your team experience the power of prevention!

Learn more Partner website Authorization

Partner's Customer Authorization form to Marketplace

Please read before completing this form(Required)

Consent to Share Data, including Patient Information between MatrixCare and the Partner Company is the company proposing this Authorization. Company has built an Integration to be able to populate data from your database(s) and/or from a static copy of your database(s) (including all facilities in an enterprise account) in the MatrixCare, Inc. ("MC") Solution that is updated from time to time, and, if applicable, bidirectionally. It is our policy to obtain consent from each of our customers before we allow their data to be shared with another company or party. We have a Business Associate Agreement in place with you, and we have been informed by MC that they also have a Business Associate Agreement in place with you for the protection of that information.

Please complete all the fields below and submit this Authorization form authorizing us to exchange data between MC and Company.

By submitting this Authorization, I, as a duly authorized representative of the Client/Customer, hereby grant my consent to the passage of data between the MC Solution and the Company Solution and represent and warrant that Customer is legally free to enter into this Authorization.

About you:(Required)
Your company information:(Required)
Primary Care Setting

Facility information for Integrations:

Click here for Customer Authorization Form FAQs to help with completing this form.
PLEASE NOTE:

You can individually add in the Facility information in the form below [Click the (+) to add multiple locations]

OR Upload a document with the facilities information. Please refer to this document for the specific formatting.

List all facilities requesting Integration
Facility Name
Facility Address
MC ID
 

ALTERNATIVELY : Upload File or list below

Accepted file types: pdf, xls, xlsx, doc, Max. file size: 50 MB.
Consent(Required)

MatrixCare offers industry-leading software solutions. Thousands of facility-based and home-based care organizations trust us to help them improve efficiency and provide exceptional care. 

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