Mychart proxy 2026

1. Click ‘Get Form’ to open the mychart proxy form in the editor.
2. Begin by filling out the Parent/Guardian Information section. Ensure you provide your name, last four digits of your SSN, date of birth, address, email, and phone number clearly.
3. Select the primary care organization from the provided list that serves your child. This is crucial for establishing access.
4. Next, complete the Child’s Information section. Fill in your child's name, last four digits of their SSN, and date of birth accurately.
5. Again, select the primary care organization for your child from the same list.
6. Review the MyChart terms and agreement carefully. Ensure you understand each point before signing.
7. Finally, sign and date the form at the bottom to confirm your understanding and agreement.

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