Get the free MyChart Proxy Application for Adolescent PatientsAge 12-17

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Chart Proxy Application for Adolescent Patients Age 1217 Completing this form allows someone else (a proxy) to be able to access all of a patients' health record via Chart. To request proxy access,

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How to fill out mychart proxy application for

01

Visit the MyChart website for your healthcare provider.

02

Log in to your own account.

03

Find the 'Proxy Access' section.

04

Select the option to request proxy access.

05

Fill out the required information about the person you are requesting access for.

06

Submit the application and wait for approval from the healthcare provider.

Who needs mychart proxy application for?

01

Patients who are unable to manage their own MyChart account due to age, illness, or other reasons.

02

Caregivers or family members who assist patients with managing their healthcare information.

03

Individuals who have legal authority to make medical decisions on behalf of the patient.

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What is mychart proxy application for?

Mychart proxy application is for allowing someone else, known as a proxy, to access and manage your healthcare information through MyChart.

Who is required to file mychart proxy application for?

Individuals who want to authorize a proxy to access their healthcare information through MyChart are required to file mychart proxy application.

How to fill out mychart proxy application for?

You can fill out the mychart proxy application by logging into your MyChart account, navigating to the proxy access section, and following the instructions provided.

What is the purpose of mychart proxy application for?

The purpose of mychart proxy application is to give individuals the ability to grant access to their healthcare information to a trusted individual, such as a family member or caregiver.

What information must be reported on mychart proxy application for?

The mychart proxy application may require information such as the name and contact information of the proxy, the relationship to the individual, and any specific permissions or restrictions on access.

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