Get Myahchart

Filling out the Myahchart form online is a crucial step in granting access to your health information to a designated proxy. This guide will help you navigate through the necessary sections with clear instructions, ensuring that the process is straightforward and efficient.

Follow the steps to efficiently complete the Myahchart form online.

1. Press the ‘Get Form’ button to access the Myahchart form and open it for editing.
2. Begin by entering your full name in the ‘Patient Name’ field.
3. Next, provide your date of birth in the designated section.
4. Fill in your address details, including street address, city, state, and zip code.
5. Input your telephone number in the corresponding field.
6. Select one of the options regarding your Myahchart status by marking the appropriate checkbox: either to sign up, indicate that you are a current patient, or that you want to sign up a proxy.
7. In the Proxy Authorization section, write the name of the individual you are authorizing as your proxy.
8. Provide the corresponding date of birth, address, city, state, and zip code for the proxy.
9. Select the gender of the proxy by checking the appropriate box for Female or Male.
10. Clearly describe the relationship you have with the proxy in the space provided.
11. If additional proxies need to be added, repeat steps 7 to 10 as necessary.
12. Review the acknowledgment statement regarding the proxy's access privileges and confirm your understanding by signing the form.
13. Date your signature in the specified area.
14. Once all sections are completed, save your changes. You can then choose to download, print, or share the form as needed.

Complete your Myahchart form online today to ensure convenient access to your health information.