Get Bon Secours Mychart

This guide provides a professional and supportive overview on how to complete the Bon Secours MyChart identification verification form. Follow these steps to ensure a seamless online experience in accessing your health information.

Follow the steps to fill out the Bon Secours MyChart identification verification form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out the patient’s information. Provide the first name, last name, middle initial, date of birth, patient member ID number, email address, and the name of the physician.
3. Designate a proxy by filling out their first name, middle initial, last name, mailing address (including street, city, state, and zip code), and any other required contact information.
4. Switch to the section for the proxy. Enter their first name, last name, middle initial, date of birth, social security number, and email address.
5. Review the information provided to ensure accuracy. Misfilled information can delay the process.
6. Complete the Proxy Acknowledgement by signing and dating the form. Your signature must then be verified by a notary public.
7. Present one of the accepted identification documents to the notary for verification. This could be your driver’s license, a passport, or a picture ID with a social security card.
8. After notarization, mail the completed form to your physician practice as indicated on the form.
9. Once submitted, await the special identification code and further instructions for activating your MyChart account.

Begin completing your Bon Secours MyChart identification verification form online today.