Get Myuhealthchart

This guide aims to provide a comprehensive overview of how to complete the MyUHealthChart form online. Whether you are a proxy seeking access to another adult's medical records or facilitating care for a loved one, following these steps will ensure a smooth process for obtaining information.

Follow the steps to fill out the MyUHealthChart form effectively.

1. Click 'Get Form' button to obtain the Adult Proxy Form and open it in the editor.
2. In the 'Your (Proxy) Information' section, fill in the required fields: name (last, first, middle initial), date of birth, last four digits of the Social Security Number, email, street address, city, state, zip, and phone number.
3. Indicate your relationship to the patient by checking the appropriate box, ensuring to attach any required legal documentation if you are a legal guardian or hold a durable power of attorney for healthcare.
4. Proceed to the 'Patient’s Information' section and accurately complete all required fields: patient name (last, first, middle initial), date of birth, last four digits of Social Security Number, email, street address, and phone number.
5. Review the MyUHealthChart Terms and Agreement thoroughly. Read each statement carefully and ensure your understanding before agreeing.
6. Sign the form in the 'Your (Proxy) Signature' section, indicating your relationship to the patient and providing the date.
7. If you are the patient or authorized representative, also complete the signature section for the patient, confirming their designation of you as a MyUHealthChart proxy.
8. Complete the 'Adult Proxy Authorization for Release of Medical Information' form, including the patient’s name, date of birth, and the proxy's name in the required fields.
9. Specify the purpose of the authorization. You may state 'at my request' for simplicity.
10. Once all fields are filled accurately, save your changes. You may choose to download, print, or share the form as necessary. Lastly, return the completed forms to a University of Miami Health System workforce member.

Complete your MyUHealthChart forms online today to ensure seamless access to important medical information.