A new consent form must be uploaded each year for the current reporting period. CMS requires a "wet signature" meaning that the form must be printed and manually signed. That signed form can then be scanned and uploaded to the MIPS Renewal order.

The consent form template is available as a download on the Renewal Order form.


  1. If you have not already downloaded the consent form template, select Click to download consent form link in the Provider(s) and Measures section.
  2. Print, sign, and scan the consent form. A form must be signed for each provider you will be reporting for individually.
  3. Select the Upload Form link for the provider.
  4. Browse to locate the file with the consent form for the current provider.
  5. Select Add. The consent form filename appears for the provider.
  6. Repeat steps 2-5 for each provider. If you have multiple providers' forms in the same file, upload that same file for each of the providers. You cannot leave a consent form as "Missing" for a provider you want to report for -- this will prevent the Submit Order button from becoming active.

Next step:

Selecting Improvement Activities for the Practice