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Get Az Honorhealth Adult Proxy Access Form For Mychart 2023-2025
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How to fill out the AZ HonorHealth Adult Proxy Access Form for MyChart online
Completing the AZ HonorHealth Adult Proxy Access Form for MyChart online is a straightforward process. This guide provides step-by-step instructions to ensure that you accurately fill out each section of the form to grant a caregiver or guardian access to your MyChart account.
Follow the steps to successfully complete the form.
- Press the ‘Get Form’ button to access the form and open it in your editing tool.
- In the Proxy Information section, clearly provide the necessary details of the individual designated for proxy access. Include their name (last, first, middle initial), date of birth, street address, city, state, zip code, phone number, and email.
- Next, complete the Patient Information section by entering the patient's name (last, first, middle initial), date of birth, gender, email, street address, city, state, and zip code.
- Both the proxy and patient must review the understanding statement and provide their signatures, along with the date, in the designated signature fields to confirm they agree to the terms outlined in the form.
- Once you have filled out the form, make sure to save your changes. You can then download or print the completed form for your records.
- Finally, submit your completed form to HonorHealth Health Information Management via email, fax, mail, or in person at one of the designated locations.
Start completing your AZ HonorHealth Adult Proxy Access Form online today to ensure seamless access to your health information.
Once logged into their own MyChart account, they can access the navigational menu and select the "Share My Record" option under the "Sharing" submenu. From this page they should select the Friend's and family access tile and then select the the + Invite Someone tile to send a proxy invite.
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