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Chart Proxy Form Access to Another Patients chart Record To request access to the chart record of an adult or child whose medical care you help manage, please complete this form. The patient must

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How to fill out mychart proxy access form

01

Go to the MyChart website or app

02

Log in to your account

03

Find the 'Proxy Access' section or form

04

Fill out the required information for the proxy, including their name and contact information

05

Submit the form and wait for approval

Who needs mychart proxy access form?

01

Patients who want to give access to a family member, caregiver, or guardian to manage their healthcare information

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What is mychart proxy access form?

MyChart proxy access form is a document that allows an individual to access and manage another person's MyChart account.

Who is required to file mychart proxy access form?

The individual who wants to access and manage another person's MyChart account is required to file the MyChart proxy access form.

How to fill out mychart proxy access form?

To fill out the MyChart proxy access form, you need to provide your information as well as the information of the person whose account you want to access. You also need to specify the level of access you are requesting.

What is the purpose of mychart proxy access form?

The purpose of the MyChart proxy access form is to allow an individual to assist another person in managing their medical information and appointments.

What information must be reported on mychart proxy access form?

The MyChart proxy access form typically requires personal information of both the requester and the account holder, as well as details on the level of access requested.

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