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Mychart Child  Form

Mychart Child Form

Use a mychart child template to make your document workflow more streamlined.

With another person that person may be able to view my or my child s health information and health information of someone who has authorized me as a MyChart proxy. Please note that your child s chart will be accessed through your MyChart record. Completing this form will establish a MyChart record for you and for your child. Return all forms to MyChart Services or fax 612-262-1424 Mail Route 10607 2925 Chicago Avenue Minneapolis MN 55407 Parent/guardian information all sections required please...
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