Wtma patient portal login 2025

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  1. Click ‘Get Form’ to open the wtma patient portal login in the editor.
  2. Begin by filling out the 'Patient Information' section. Enter your name, sex, street address, city, home phone number, date of birth, last four digits of your SSN, state, work phone number, and mobile number.
  3. Next, move to the 'Proxy Information' section. Here, specify the individual whose access you are revoking by entering their name, sex, street address, city, date of birth, last four digits of their SSN, state, zip code, and their relationship to you.
  4. In the 'Patient Authorization' section, review the terms carefully. Sign and date the form where indicated. If applicable, provide details about your legal authority if signing on behalf of another individual.
  5. Finally, return the completed form to the Health Information Management Department at WTMA as instructed.

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2015 4.6 Satisfied (67 Votes)
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