Get Mychart Minor Registration Form 05.141405262015

Filling out the MyChart Minor Registration Form 05.141405262015 is an essential step for parents and guardians who wish to gain online access to their minor child's health information. This comprehensive guide will assist you in completing the form accurately and efficiently.

Follow the steps to complete the registration form successfully.

1. Select the ‘Get Form’ button to access the registration document and open it in the editing interface.
2. Provide the minor’s information in the designated fields. Ensure that all fields are completed accurately, including the last name, first name, middle initial, medical record number, street address, date of birth, city, state, zip code, email address, best phone number, and primary clinic.
3. Affirm your identity by signing the section which states that you affirm the information provided is truthful. Include the date to validate your submission.
4. Submit the completed form through one of the three available methods: return it in person to the front desk at your clinic, mail it to Austin Regional Clinic MyChart Support at the provided address, or fax it to the designated fax number.
5. Keep a copy of the submitted form for your records. Once submitted, you may check back with the clinic for confirmation of MyChart access being granted.

Start filling out your MyChart Minor Registration Form online today to ensure easy access to your child’s health information!