By submitting this form, I authorize Brodha Health to share my health information with its partner hospitals, clinics, and healthcare providers for the purpose of medical treatment or consultation. I understand that I can revoke this consent at any time by notifying Brodha Health via email or in writing, and such revocation will not affect any disclosures made prior to that date. This consent remains valid until I choose to withdraw it. By checking the box, I confirm that I have read, understood, and agree to these terms.
