Family Access

You may request access to view information on your family members and securely communicate on their behalf using MyChart. Access is granted once signed authorization forms (links to forms provided below) are received. Please note, MyChart is currently only available to patients who are receiving medical care from a Physician or Advanced Practitioner.

Once you have completed the forms, please take them to your family member's Physician or Advanced Practitioner's Office.

Child Under 12 Proxy Sign Up Form

Please print this form
Note: A separate form will need to be completed for each child.

Adult Proxy Form

Please print this form

Special Circumstances

  • Access to a Minor: If legal decisions, rulings, or judgments related to parental rights have been made that could impact MyChart access to a child's record, please provide copies along with the authorization form.
  • Mental Competency: If an adult patient is not mentally competent to authorize access to their record, please provide copies of relevant legal documents (Guardianship Letter, etc).