MyChart - Sign Up

This is to request an account for yourself. All of the information must be entered exactly as your government issued ID and match the information on file for the processing of your request to be successful. In the next step we will verify your identity using questions from a third-party verification system. Once verified, you will be able to activate your MyChart account.

Not sure how to sign up? Click here to watch a video.

If you would like proxy access to another patient’s MyChart account, please click here for instructions.

Indicates a required field

First name

Middle name

Last name

Date of birth

Legal sex

FemaleMaleUnknown

Home phone

Mobile phone

Email address

Verify email address

Medical record number

REQUIRED: Please read the statements below and click the checkboxes.

By checking this box: (1) I confirm that I have read this notice, (2) I agree that I am providing written instructions to Memorial Healthcare System (Memorial) under the Fair Credit Reporting Act that authorize Memorial to obtain from Experian Health information from my personal credit profile or other information to verify my identity and assess my eligibility for services, and (3) I authorize Memorial to obtain such information prior to activation of a MyChart account in my name solely to confirm my identity to avoid fraudulent transactions in my name.

I acknowledge review and receipt of MHS Notice of Privacy with a link to this page. https://www.mhs.net/privacy-and-security/hipaa