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Get the free mychart.fmolhs.orgMyCharten-usMyChart Teen Proxy Form - Franciscan Missionaries of O...

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TEEN PROXY Formulas complete the following information for access to a teens (1217) Chart account at Duly Health and Care (Duly). Proxy access for minors under 17 years of age will only be granted
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How to fill out mychartfmolhsorgmycharten-usmychart teen proxy form

01
Go to the MyChart website: mychart.fmolhs.org/MyChart/en-us/MyChart.
02
Log in using your own account credentials.
03
Click on 'Profile' and then 'Request Family Access.'
04
Select the teenager you would like to proxy for and click 'Submit.'
05
Review and accept the terms and conditions.
06
Fill out the necessary information and click 'Submit.'

Who needs mychartfmolhsorgmycharten-usmychart teen proxy form?

01
Parents or legal guardians who want to access their teenager's medical records and manage their healthcare needs.
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The mychartfmolhsorgmycharten-usmychart teen proxy form is a form that allows a teen to designate a proxy to access their medical records and information.
Teens who are 18 years old or younger are required to file the mychartfmolhsorgmycharten-usmychart teen proxy form.
To fill out the mychartfmolhsorgmycharten-usmychart teen proxy form, the teen must provide their information, as well as the information of the designated proxy.
The purpose of the mychartfmolhsorgmycharten-usmychart teen proxy form is to allow a teen to grant permission to a designated proxy to access their medical records.
The mychartfmolhsorgmycharten-usmychart teen proxy form must include the teen's personal information, as well as the information of the designated proxy.
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