Minor child proxy 2026

1. Click ‘Get Form’ to open the Minor Child Proxy Form in the editor.
2. Begin by filling out the Parent/Guardian Information section. Clearly print your name, date of birth, sex, address, and contact details. Ensure all fields are completed accurately.
3. Next, provide your child's information in the Child Information section. Include their name, date of birth, and address. This information is crucial for establishing access.
4. Review the MyChart Terms and Agreement carefully. Acknowledge your understanding by signing at the bottom of the form. This confirms you are the legal guardian.
5. Once completed, save your document and return it as instructed—either by mail or fax—to ensure timely processing.

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