Authorization of Personal Representative Form
If you would like to authorize someone else to call HNE and discuss your information, mail the completed form, signed, to HNE's Enrollment Department at One Monarch Place, Springfield, MA 01144. (Please note: the authorization is valid only if signed.) You may revoke the authorization at any time by sending a letter to us at the same address. For more details, see also our Notice of Privacy Practices.

HNE Personal Health Record