MyChart Proxy Access Frequently Asked Questions


What is proxy access?
Proxy access lets you attach another MyChart account to yours. Depending on the type of proxy granted, you may have 24-hour access to:

  • Appointments
  • Immunizations records
  • Medicine refills
  • Secure messaging with the patient's care providers
  • More


What types of proxy access are available and what forms do I need to fill out?

Adult-Child: Access to the MyChart account of your child who is under the age of 18.

Age range limitations apply, but do not affect legal rights to access the record by other means.

o Age 0-11 years: Full access to your child's MyChart account is granted.

Download and complete this form if your child is 0-11 years old.

MyChart Proxy Access Sign Up

o Age 12-17 years: Partial access to your child's MyChart account is granted. This is due to privacy laws.

Download and complete this form for limited access if your child is 12-17 years old.

MyChart Proxy Access Sign Up

Young Adult: Children age 14 through 17 can have their own MyChart account with parental permission.

Parents can request full access to this account with written permission from the child.

Download and complete this form.

MyChart Proxy Access Sign Up

Adult-Adult: Access to the MyChart account of a person who is over the age of 18. Written permission must be obtained.

Download and complete these two forms.

MyChart Proxy Access Sign Up

MyChart Adult Proxy Authorization Release of Information (to be completed by the person whose

account you are asking access to)

Adult (Legal Guardian)-Diminished Capacity Adult: Access to the MyChart account of a person for whom you

have legal authority to make health care decisions. Legal documentation to support your Guardianship or

Power of Attorney must accompany your request form.

Download and complete this form.

MyChart Proxy Access Sign Up


    How do I get/give proxy access?
    Complete the appropriate form(s) and mail, fax or deliver to:

    Health Information Management Identity - Data Integrity
    N17 W24100 Riverwood Drive, Suite 200
    Waukesha, WI 53188
    Fax: (262)544-9489

    How do I take away access from someone who has proxy to my MyChart account?
    To inactivate access to your account, download and complete this form. Mail, fax or deliver to the above address.
    MyChart Inactivation form

    What happens after I send in the completed forms?
    Once we receive your forms and proxy access is granted, access instructions will be sent to your MyChart account. If you do not have a MyChart account, the access instructions will be sent by U.S. mail to the address provided on the form.

    If have proxy access to another MyChart account, can I do a virtual visit with them?
    Yes. You must have proxy access to the MyChart account of the person whom the virtual visit is for and be in that account when scheduling the appointment and starting the visit.

    Who can I contact if I have questions?
    If you have questions or would like the proxy forms mailed to your home, call (877) 873-6305. MyChart support is available to assist you 24-hours a day, 7 days a week.