You can talk to your doctor's office during your next visit and they can generate your access code. You will also receive sign up instructions so you know how to use the new access code and start using MyChart.
Want to start the process now? You can request an activation code online for your personal MyChart account or use one of the forms below.
PLEASE NOTE: A Spanish version of the Sign Up Form is available for download. However, please keep in mind that our MyChart site is in English only and does not currently have a Spanish version. We're providing Spanish versions of the forms for your convenience during the sign up process.
Pick the form that is right for you from the list below. If you plan to set up an account for your family, choose the appropriate "Proxy Access" form to set up access for you and your child or an adult family member. There is no need to submit two forms, just the Proxy access form.
|Edward-Elmhurst Health Sign Up Forms|
|• Download Self Sign Up Form
|• Download Child Proxy Form
For children less than 18 years of age. Teen access is limited. Click here for more information
|• Download Minor (12-17yrs) Proxy Form
For children 12 to 17 years of age. Provides expanded access and must be signed by adult and child in person. Do not mail: Submit to physician's office to be processed Click here for more information
|• Download Adult Proxy Form
For access to another adult's health record if you help manage that adult's medical care
|• Descargar Formulario de Inscripción (Español)
|• Descargar Formulario de Apoderado de Niño (Español)
Para los niños menores de 18 años de edad
|• Descargar Formulario de Apoderado de Menor (12 a 17 años) (Español)
Para niños de 12 a 17 años de edad
|• Descargar Formulario de Apoderado de Adulto (Español)
Para el acceso a los registros de salud de otro adulto si usted ayuda a administrar la atención médica de ese adulto
Yes, this is called "proxy" access. For a child under 12, this allows a legal parent or guardian to log into their personal MyChart account, and then connect to information regarding their child. Per State guidelines, after the child becomes 12 the parent will have access to appointments and be able to send messages but will have limited access to the child's medical record information unless an expanded access form is signed by parent and teen. Access will not expire until the child turns 18, the parent can get access to the patient's medical record information with the patient's authorization. It is also possible to request access to another adult's health record if you help manage that adult's medical care.Return to Top