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Get BSWH MyChart Minor Child Proxy Form

I make may become part of the medical record. I understand that access to MyChart is provided by Scott & White Healthcare as a convenience to its patients and that Scott & White Healthcare has the right to deactivate access to MyChart at any time for any reason. I understand that use of MyChart is voluntary and I am not required to use MyChart or to authorize a MyChart proxy. If the proxy’s legal relationship with the account holder changes, Scott & White Healthcare must be informed immediate.

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