Mychart-val.conehealth.com

PARENT / GUARDIAN ACCESS TO A CHILD’S MyChart …

WebCone Health, Department of Health Information Management, 1200 N. Elm St., Greensboro, NC 27401. Email forms to: [email protected]. Present signed form at your child’s Cone Health provider location. We will email an activation code to the email address you provide below. Use the activation code to set up your MyChart …

Actived: 6 days ago

URL: https://mychart-val.conehealth.com/MyChartVAL/MyChart%20Child-Proxy-Form.pdf

MR99119 Access to Another Adults MyChart

WebInstructions: This form should be completed by the patient and by the adult the patient is authorizing to access medical information in his or her MyChart record. The authorized adult will be referred to as the patient’s proxy. Please complete the second page of this form and return it to any of the addresses shown below.

Category: Medical Go Health

PARENT / GUARDIAN ACCESS TO A CHILD’S MyChart …

Web1 MR99118SP (09/20) PARENT / GUARDIAN ACCESS TO A CHILD’S MyChart® ACCOUNT ACCESO DE PADRES/ GUARDIÁN LEGAL A LA CUENTA DE MyChart® DE UN(A) NIÑO(A) Instrucciones: Para registrarse para tener acceso al historial médico de MyChart de su niño(a), por favor llene la segunda página

Category: Health Go Health