Mychart cone 2025

1. Click ‘Get Form’ to open the mychart cone in the editor.
2. Begin by entering your Patient Name, Social Security Number, and Date of Birth in the designated fields. Ensure that all information is accurate for proper identification.
3. In the section requesting the name of your designated proxy, clearly write the full name of the individual you wish to authorize access to your MyChart record.
4. Review the authorization statement carefully. This confirms that you understand what information will be shared and with whom. Make sure to check any relevant boxes regarding sensitive information if applicable.
5. Sign and date the form at the bottom. If someone else is signing on your behalf, indicate their relationship to you and attach any necessary documentation.
6. Complete page 2 of this form as required, ensuring all sections are filled out clearly before submission.

Start using our platform today for free to streamline your MyChart form completion!