
• Social Security Number
• Date of Birth
• Health Insurance Information
• Treatment Information
• Billing Information
• Diagnosis
• Phone Number
• Email Address
• Provider Name
• Medical Record Number
• Passport Number
• Username and Password
• Signature
• Mother’s Maiden Name
• Name
• Prescriptions
• Health Insurance Policy Number
• Medical History
• Dates of Service
• Procedure Information
• Driver’s License/State ID Number
• Genetic Data
• Medicare/Medicaid ID Number
• Foreign National ID Number
• Covid Test Result/Vaccination Status