Get the free MyChart Proxy Request - Tomah Memorial Hospital

501GopherDrive Torah,WI54660 (608)3722181FINANCIAL ASSISTANCE APPLICATION Date: PERSONAL INFORMATIONPatientsName: DateofBirth: Address(Street, City, State, andZipcode): Phone(Honeywell): BestTimeToCall:

How to fill out mychart proxy request

How to fill out mychart proxy request

1. To fill out a mychart proxy request, follow these steps:
2. Log in to your mychart account using your credentials.
3. Navigate to the 'Settings' or 'Profile' section of your mychart account.
4. Look for the option related to proxy access or sharing your mychart account.
5. Click on the option to request proxy access.
6. Fill out the required information, including the name and contact details of the person you wish to grant proxy access.
7. Provide any additional information or reasons for the request, if required.
8. Review the request form to ensure all information is accurate.
9. Submit the request form and wait for approval from the mychart administrator.
10. Once approved, the person you designated will have access to your mychart account as a proxy user.
11. Note that proxy access can be revoked at any time if needed.

Who needs mychart proxy request?

1. Mychart proxy request is needed by individuals who want to grant someone else access to their mychart account, such as family members, caregivers, or legal representatives.
2. This can be useful in situations where the account holder is unable to manage their mychart account on their own or requires assistance in accessing their health information.

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What is mychart proxy request?

MyChart proxy request refers to a formal request allowing a designated person to access and manage a patient's health information and medical records through the MyChart system.

Who is required to file mychart proxy request?

Patients who wish to grant access to their health information to another individual, such as a family member or caregiver, are required to file a MyChart proxy request.

How to fill out mychart proxy request?

To fill out a MyChart proxy request, you typically need to provide your personal information, details of the person you wish to designate as a proxy, and sign the necessary consent form, either online or on paper, as specified by the healthcare provider.

What is the purpose of mychart proxy request?

The purpose of the MyChart proxy request is to grant a trusted individual access to your medical records and health information, enabling them to assist in managing your healthcare.

What information must be reported on mychart proxy request?

The MyChart proxy request must include the patient's name, date of birth, contact information, the name of the proxy, the proxy's contact information, and any specific permissions granted.