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MYBMGCHART PROXY ACCESS REQUEST (MINOR/INCOMPETENT PATIENT) To request access to the record of a minor or incompetent adult patient through MyBMGChart, please complete this form. Please note that

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How to fill out proxy access request

01

Step 1: Obtain a proxy access request form from the appropriate authority or organization.

02

Step 2: Read the instructions and requirements mentioned on the form carefully.

03

Step 3: Fill in your personal details such as name, address, contact information, and any other required information.

04

Step 4: Clearly indicate the reason for your proxy access request and provide any necessary supporting documents.

05

Step 5: Review the completed form for accuracy and ensure all sections are properly filled out.

06

Step 6: Sign and date the proxy access request form.

07

Step 7: Submit the completed form to the designated authority or organization either in person, by mail, or through any specified method.

08

Step 8: Keep a copy of the filled-out form for your records.

09

Step 9: Follow up with the authority or organization to ensure the processing of your proxy access request.

10

Step 10: Wait for confirmation or notification regarding the approval or denial of your proxy access request.

Who needs proxy access request?

01

Shareholders or investors who are unable to attend a specific meeting due to scheduling conflicts or distance.

02

Individuals who wish to designate someone else to represent their voting rights and interests at a meeting.

03

Those who want to have a voice and vote on matters discussed or decided at a meeting without physically being present.

04

Proxy access requests are also used by organizations or groups seeking to advocate for specific agendas or goals.

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