Proxy access to a family member's Memorial MyChart health information offers the following benefits:
Step 1 The person requesting proxy access to a family member's or child's account must have their own personal Memorial MyChart account.
If you don't have a Memorial Mychart account, you can get one by Requesting an activation code. You can also obtain a MyChart activation code from your participating MyChart doctor's office.
Once you activate/have access to your personal MyChart account follow step 2 for requesting proxy access for an Adult, Child (Under age 13) or Teen (13-18)
Step 2 Once you have access to your personal MyChart account you can request proxy access to either an adult account or a child account.
There are 2 options to request and grant proxy access for an adult patient's MyChart
To request access to an adult family member’s Memorial MyChart account, complete and submit the forms below in-person at your Memorial provide's office. Both the patient and the person requesting access must be present and have a medical record (MRN) with Memorial. If you are unable to come in person email the form to mychart@mhs.net with a picture of a goverment issued photo ID (This method requires a review by an authorized Memorial employee and can take 1-2 business days from the moment the forms are submited).
There are 2 options to request proxy access for a child's MyChart information.
Click on Request access to a child's (Under age 13) MyChart account.
Complete the form with your child's demographic information.
Important: Please make sure to read the statement and click to acknowledge to submit the request.
Submit the request. Please allow 24-48 business hours for the resquest to be reviewed.
Please complete the Child Request for Parental Proxy Form (PDF). Attach it with the parent or guardian goverment issued photo ID and email it to us at mychart@mhs.net for assistance. Please allow a 3 business day for a reply.
Access to a child’s Memorial MyChart health information changes when he or she turns 13, because state and federal law protect the privacy of pediatric patients seeking medical treatment for pregnancy, sexually transmitted disease, substance abuse, and mental health issues.
Teen consent is required for parents or legal guardians to access their teen’s MyChart health information. Teen MyChart Access is only available to teens who grant consent to a parent or legal guardian; however, a teen may revoke such consent at any time. Teen MyChart Access expires at age 18.
There are 2 options to request proxy access for a child's MyChart information.
Click on Request access to a teen's (13 to 18th birthday) MyChart account.
Complete the form with your child's demographic information.
Important: Please make sure to read the statement and click to acknowledge to submit the request.
Submit the request. Please allow 24-48 business hours for the resquest to be reviewed. We will contact your teen to get verbal consent to grant you access.
Please complete the Teen Proxy Authorization form (PDF). Please make sure it includes your teen's signature. Attach the form with the parent or guardian goverment issued photo ID and email it to us at mychart@mhs.net for assistance. Please allow a 3 business day for a reply.