Abstract: A health care network that is used by doctors, patients, nurses, DME offices, hospitals, etc. employs digital signatures and/or electronic image signatures for providing authentication, approval support, as well as security while accessing documents and other information. Electronic image signatures are attached to provide information about the approval, by physicians, of DME related documents and certificates of necessity. Electronic image signatures are used along with digital signatures to authenticate the documents and other information. When a user, such as a doctor, signs a document, such as a patient's documents, an electronic image signature of the user is selectively employed, along with the user's digital signatures that are based on public and private keys, to authenticate the user and determine the identity of the signer. Such a mechanism makes it possible to employ the electronic image signature as proof of the user having signed the document.