MyChart Proxy Access
How to access your child's medical records via MyChart
Proxy Access Forms are now available to access your child’s medical records in MyChart. Forms can be filled out in the physician’s office at the time of your visit. Please be aware, depending on the child’s age, you will need either one or both forms to receive approval.
A parent or legal guardian must sign the Child/Teen Proxy Access Request Form regardless of the child’s age.
- To sign up for access to your child's MyChart record, please complete the form in its entirety. Completing the form allows access to portions of the patient's protected health information maintained by Erlanger Health System through MyChart.
If the child is between the ages of 12 and 17, the child must sign the 12-17 Year Old Patient MyChart Agreement.
- To sign up for you and your parent/legal guardian to have access to your MyChart record, please complete the form in its entirety. Completing the form allows access to your protected health information maintained by Erlanger Health System through MyChart.
There is also another form for adults granting other individuals permission to access their MyChart account. This form is titled Adult (18+) Proxy Access Request Authorization Form and can be used for parents, spouses, legal guardians, Durable Power of Attorney, and other. Both the patient and the requestor must sign for access.
Correct forms must be filled out, signed, and scanned by authorized Erlanger associates before access is granted.
For more information or to access the forms, please visit your physician’s office.