Proxy Access to Your Family’s Health Information
Proxy access to a family member’s Memorial MyChart health information offers the following benefits:
- View your family’s medical information online
- Review medications and health history
- Receive most test results online
- Review discharge instructions and health topics
- Stay in touch with your family’s physicians
- Send secure messages to a Memorial MyChart doctor
- Request medication renewals online
- Manage your family’s appointments
- Request an appointment
- View details of past and upcoming appointments
How to get started
To request access to a family member’s Memorial MyChart account, complete and submit the forms below to the patient’s Memorial MyChart doctor’s office or to any Memorial Health Information Management Department. Both the patient and the person requesting access must have a Memorial Medical Record Number.
- Proxy Access for Adults
Proxy Access for a Child Younger than Age 13
Request for Parental Proxy (PDF)
To be completed by child's parent or legal guardian
- Request for Parental Proxy (PDF)
Access to Your Teen's Health Information
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. Memorial MyChart access is available to teens ages 13-17.
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.
Patients ages 13-17 may complete the Teen Proxy Authorization form (PDF) to grant their parent or legal guardian online access to their Memorial MyChart health information.