Let's make it HIPAA official.
Authorization to Disclose Protected Health Information By clicking “I agree” below, I authorize each of my child’s physicians and any other healthcare provider (together “Healthcare Providers”) to disclose his or her individually idetifyable health information, (“Protected Health Information”) to TheraWe Connect (“TheraWe”) for the purposes described below. Specifically, I authorize my child’s Healthcare Providers to receive, use, and disclose my child’s Protected Health Information to: (i) enroll my child in and contact me about, the TheraWe integrated therapy platform; (ii) aggregate data; and (iii) help improve the TheraWe platform. I understand that my child’s Protected Health Information will not be used or disclosed by TheraWe for any other purpose unless permitted by law. I understand that TheraWe will make every effort to keep my child’s Protected Health Information confidential. This information, once it is disclosed, may no longer be protected under federal law. This authorization will remain in effect until I no longer enroll my child in the TheraWe platform. I understand that I may cancel or revoke this authorization at any time by informing my Healthcare Providers in writing that I do not want them to share any information with TheraWe, but this will not affect TheraWe’s ability to use and disclose Protected Health Information that it already received. My authorization will also end if the TheraWe platform is discontinued. I understand that I am not required to sign this Authorization. My choice about whether to sign will not change the way my child’s Healthcare Providers treat me or my child. If I refuse to sign this Authorization, or revoke my authorization later, I understand that I will not be able use the TheraWe platform. Further, I acknowledge that all my questions have been answered to my satisfaction, and I agree to all of the provisions contained above.
I agree! I agree! By proceeding, you agree to the HIPAA agreement
& Terms and Conditions.
{{fullName}}, let's create your account!
Type of Therapy {{type.name}} NEXT
{{fullName}}, let's create your account!
PHONE NUMBER NEXT
Tell us about your awesome kiddo.
CHILD FIRST NAME CHILD LAST NAME CHILD BIRTHDATE CONDITION OR DIAGNOSIS (OPTIONAL) NEXT
Add more caregivers for updates?
TheraWe enables unlimited family
members and caregivers to get video
updates of each session for your kiddo.
Let's invite your first care team member.
NEXT
SKIP
Want to add another therapy organization?
TheraWe offers unlimited therapy providers
and cross organization collaboration
between organizations, schools, and
private therapists.
Let's add your other therapists
to improve collaboration.
THERAPY ORGANIZATION NAME CITY THERAPIST FIRST NAME THERAPIST LAST NAME THERAPIST EMAIL NEXT
SKIP

Success!

Your account is created.
We sent you a welcome email.
Go to your app store to download.
Login and crush your pediatric therapy.
DOWNLOAD Continue To Web Version