Get Myloyola

Filling out the Myloyola Select Proxy Access Authorization Form is an essential step for parents or legal guardians to gain access to their child's medical information. This guide provides comprehensive instructions on how to effectively complete the form online, ensuring that you provide all necessary information accurately.

Follow the steps to successfully complete the Myloyola form.

1. Click the ‘Get Form’ button to obtain the form and open it. This will allow you to start filling out the necessary fields.
2. Enter your LUHS medical record number in the designated field. Ensure that this number corresponds to your myLoyola Select account.
3. Provide your full name where indicated. It is important to enter your name accurately as it appears on your account.
4. Specify your relationship to the child in the appropriate section. This provides clarity about your role as a parent or legal guardian.
5. Fill in your address, including street, city, state, and zip code. Make sure this information is up to date and correct.
6. Enter your date of birth in the specified format. This helps verify your identity.
7. Provide your social security number in the dedicated field. Ensure this information is accurate for verification purposes.
8. Fill out your phone number, making sure to include the area code. This is essential for contact purposes.
9. Enter your email address. Ensure it is currently active and accessible.
10. Next, you will need to enter your child's information in the specified sections. Repeat the previous steps (steps 2-9) for your child, ensuring all data is accurate.
11. Once all required fields are filled out, review your information carefully to confirm its accuracy.
12. After reviewing your entries, you may choose to save changes, download, print, or share the form as needed.

Complete the Myloyola Select Proxy Access Authorization Form online today for efficient access to your child's health information.