Click on the question below to see more information and links to download MyChart-related forms.
With MyChart you can securely view your medical history, request physician office appointments, request prescription renewals and more from anywhere in the world. And best of all, it’s free! So get connected to your health information with MyChart.Return to Top
Before using the MyChart site, you first need to complete one of the Sign Up Forms below and submit it to receive an access code. You can also talk to your doctor’s office during your next visit and they can generate your access code. You will also receive sign up instructions so you know how to use the new access code and start using MyChart.
Want to start the process now? You can download the Sign Up Form (choose from the list below). Fill out the appropriate form and fax or mail it back to us using the contact information on the form. Or you could bring the completed forms with you to your next office visit.
PLEASE NOTE: A Spanish version of the Sign Up Form is available for download. However, please keep in mind that our MyChart site is in English only and does not currently have a Spanish version. We’re providing Spanish versions of the forms for your convenience during the sign up process.
Pick the form that is right for you from the list below. If you have an Edward and DMG physician, you can select either form to sign up – you do not need to complete two forms. If you plan to set up an account for your family, choose the appropriate “Proxy Access” form to set up access for you and your child or an adult family member. There is no need to submit two forms, just the Proxy access form.
|DuPage Medical Group Sign Up Forms|
|Download Sign Up Form|
|Download Sign Up Form (Spanish)|
|Download Child Proxy Form|
|Download Child Proxy Form (Spanish)|
|Download Minor Proxy Form|
|Download Minor Proxy Form (Spanish)|
|Download Adult Proxy Form|
|Download Adult Proxy Form (Spanish)|
Yes, this is called “proxy” access. For a child under 12, this allows a legal parent or guardian to log into their personal MyChart account, and then connect to information regarding their child. Per State guidelines, after the child becomes 12 the parent will have access to appointments and be able to send messages but will have limited access to the child’s medical record information. Once the child turns 18, the parent can get access to the patient’s medical record information with the patient’s authorization. It is also possible to request access to another adult’s health record if you help manage that adult’s medical care.
For more information, please read our Proxy Access FAQ. To sign up for proxy access, talk to your doctor's office. Or you can download the Child Proxy Form found in the list above (for adults accessing the MyChart records of children or teens) or the Adult Proxy Form found in the list above (for adults accessing the MyChart records of other adults). You can fill out the appropriate form and send it to the fax number or mailing address listed on the form. Our Health Information Management (HIM) department will complete your request and let you know when you have access to your family member's record.
PLEASE NOTE: Spanish versions of the Proxy Forms are available for download. However, please keep in mind that our MyChart site is in English only and does not currently have a Spanish version. We’re providing Spanish versions of the forms for your convenience during the sign up process.Return to Top