• Add your voice. Help advance knowledge of medication safety to improve health outcomes for you and thousands of patients like you who take the same medications & manage the same health condition.

Required forms

As part of registration, you will be asked to complete several forms.

HIPAA authorization

Health Insurance Portability and Accountability Act form: this form is available directly from your doctor or pharmacist. It allows your healthcare provider to contact NMSOAP on your behalf and help you get successfully enrolled. In many cases, you may already have a signed HIPAA form on file with your provider. Your doctor or pharmacist will submit your signed HIPAA form to the NMSOAP system.

Informed Consent form

This electronic form (e-form) authorizes your participation in NMSOAP and also authorizes the use of relevant information from your electronic health record. This will allow your survey responses and electronic health record to be uploaded to the NMSOAP database. Your information will be de-identified (loaded anonymously), encrypted and aggregated with data from thousands of other NMSOAP participants to show any emerging medication trends and patterns. When you are registering online, the form can be signed electronically.

Release of Records

This e-form authorizes your physician or pharmacist to transfer relevant information from your electronic health record to the NMSOAP database, where this is de-identified, encrypted and aggregated to protect your privacy. This form can also be signed electronically.