MIC Physician Portal Access Request and Agreement

This Agreement, as amended from time to time, governs your use of MIC’s Physician Portal (MICConnect) and applies when you access this service to review patient images and reports.

  1. By signing this agreement you acknowledge that you have read and understood all requirements for the use of this service and failure by you or your affiliates to comply with these requirements may result in the suspension or termination of this service. You further agree that you or your affiliates have read and fully understands the Alberta Health Information Act and the requirements for the safety and confidentiality of identifying health information.
  2. Use of Information: Use of information accessed via MICConnect is intended to support continuing patient care and only information relevant to this purpose is to be accessed.
  3. Access to images and reports: You understand and agree that access to information only applies while at the facility(s) indicated within this agreement. You may view images and reports, but may not copy or store them unless using an industry standard and in compliance with the Alberta Health Information Act.
  4. Monitoring and Audits: MIC will conduct periodic monitoring and audits for appropriate searches.
  5. Use: You must use your user account ID and Password to access the physician portal.
  6. Passwords: You agree to keep your Password confidential; it is for your use only. You will not disclose to others your Password. A complex password (8 alpha numeric characters of upper and lower case) is required.
  7. Notification of Changes: It is the MICConnect administrator’s responsibility to notify Medical Imaging Consultants of any change of status of individuals listed within this agreement.

Clinic Information

Applicant Information* Must be a registered practitioner *

I (the applicant identified above) WILL NOT be registering as the MICConnect Administrator.

Administrator Information