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Chart Access Request Form PatientProxyPatient & Protection A: Patient Information (Please read and acknowledge the information on the reverse. ) Last Name First NameMiddle InitialHealth Card #Date

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How to fill out mychart proxy access request

01

Log in to your MyChart account

02

Navigate to the 'Profile' section

03

Under 'Profile', select 'Request Proxy Access'

04

Fill out the necessary information for the individual you are requesting access for

05

Submit the request for approval

Who needs mychart proxy access request?

01

Patients who want a designated individual to have access to their MyChart account for managing appointments, viewing test results, and communicating with healthcare providers

02

Legal guardians or caretakers of patients who need access to their medical information

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What is mychart proxy access request?

MyChart proxy access request allows a MyChart user to grant another person access to their MyChart account. This is often done for caregivers or family members to access health information on behalf of the user.

Who is required to file mychart proxy access request?

A MyChart user who wishes to grant access to another person, such as a caregiver or family member, is required to file a MyChart proxy access request.

How to fill out mychart proxy access request?

To fill out a MyChart proxy access request, the user must log in to their MyChart account, navigate to the settings or profile section, and find the option to grant proxy access. They will need to provide the name and email address of the person they wish to grant access to.

What is the purpose of mychart proxy access request?

The purpose of a MyChart proxy access request is to allow another person to access the user's health information and potentially communicate with healthcare providers on their behalf.

What information must be reported on mychart proxy access request?

The information required on a MyChart proxy access request typically includes the name and contact information of the person being granted access, as well as their relationship to the user.

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