Follow the steps to complete your Mystlukes enrollment form online.

1. Click the ‘Get Form’ button to access the Mystlukes enrollment form and open it in your preferred editor.
2. Begin by entering your name in the designated section. Ensure to provide your last name as it appears in your medical records.
3. Enter the last four digits of your Social Security number. This information is necessary for verification purposes.
4. Fill in your date of birth in the requested format. This helps confirm your identity.
5. Provide your phone number so that St. Luke's can contact you regarding the enrollment.
6. Input the email account you would like to use for accessing the Mystlukes Patient Portal. Make sure this email is active and secure.
7. Select the appropriate option that identifies your relationship with St. Luke's, either as a hospital patient or a medical group patient.
8. If you chose 'St. Luke’s Hospital Patient,' enter the date of your hospital admission. If not, list the names of your medical group practices and providers.
9. Read the authorization statement carefully. Ensure you understand the implications of sharing your Mystlukes ID and password, as well as your rights concerning medical information.
10. Sign and date the form to confirm your understanding and agreement with the terms stated above.
11. Choose to mail or fax the completed form to the Health Information Services at St. Luke’s Hospital, using the provided addresses.
12. For any questions about the form or the process, use the provided contact number for assistance.

Take the next step in managing your health by completing your Mystlukes enrollment form online today.