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Uest and authorization form is received. PATIENT TO BE ENABLED FOR PROXY ACCESS: Name: Date of Birth: Email: Address/Phone #: / PROXY (PARENT/LEGAL GUARDIAN): I am requesting access to the medical information available on MyChart at NYU Langone for the patient named above and agree to abide by the above terms and conditions of MyChart at NYU Langone and all other terms and conditio.

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How to fill out the MyChart NYU online

This guide provides step-by-step instructions for completing the MyChart NYU online proxy access request and authorization form for children aged 0-11 years. Ensuring that the form is filled out correctly will facilitate access to your child's medical information efficiently and securely.

Follow the steps to complete the MyChart NYU form.

  1. Press the ‘Get Form’ button to obtain the form. This will allow you to open the document in the appropriate editing platform for your convenience.
  2. Begin by providing the information for the patient who will be enabled for proxy access. This includes the patient’s name, date of birth, email address, and address along with the phone number.
  3. Next, move to the section designated for the proxy, who is typically the parent or legal guardian requesting access. Enter your name, date of birth, email address, and address with the corresponding phone number.
  4. After entering personal information, you will need to sign the form to authorize the access. Ensure you also indicate your relationship to the patient clearly.
  5. Review all entries carefully to confirm that all required fields are completed accurately. Any errors may delay the authorization process.
  6. Once all information has been verified, you can save the changes, download the form, print it out, or share it with your provider's office as instructed.

Complete your MyChart NYU proxy access form online today to ensure seamless access to your child's medical records.

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If they are a patient at NYU Langone, they can create their account online. If they are not a patient at NYU Langone, they must call our MyChart Help Desk at 866-262-6458 so that we may create an account for them.

If you are a patient at NYU Langone and don't yet have an account, you can create your account online. If you are not a patient at NYU Langone, please call our MyChart Help Desk at 866-262-6458 so that we may create an account for you.

Our patient portal, NYU Langone Health MyChart, gives you access to schedule or change appointments, view your test results, communicate with your doctor, and more.

Download our app and sign in with your NYU Langone Health MyChart username and password to stay connected to your care. If you don't yet have a MyChart account, you can create your account now.

Tap Add a document or Image to upload an image or document for your upcoming appointment. You will need to have image or document files on your mobile device. If you do not have images available, you will have the option of capturing images or documents using your mobile device during the upload process.

Who do I contact if I have questions about enrolling? Please call our NYU Langone Health MyChart Patient Help Desk at 866-262-6458.

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