Name: | DOB: | MRN: | PCP:

Request an Activation Code: Account Type

Please note: your activation code will be mailed or emailed within 7-10 business days after you submit this request.

Request proxy access to a patient account

Proxy accounts are available to parents/guardians of minor patients. Proxy access includes access to all information available on MYchart up to age 18. Once the patient turns 18, proxy access is automatically removed and may only be reinstated upon request and permission from the adult patient.

If the patient is under 18:
Request proxy access to a child's medical record.

If the patient is over 18 and willing to provide consent for you to access his medical record:
Request proxy access to an adult's medical record.

If the patient is over 18 and unable to provide consent because of diminished capacity:
Request proxy access to an adult's medical record.


Request access to your own account

Teen accounts are available to patients age 13-17 and will allow teen patients access to their own MYchart information with their parent/guardian's consent. Patients 18 and older may have full access to their own account.

NOTE: Parent/guardians must provide consent for patients 13-17 to access their medical records.

Request access to your own medical record.