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MyChart Access Forms



Activation Code Request for Myself

If you are 18 years or older, please go to the Sign up for your MyChart Account page. You will be able to sign up directly for MyChart after answering a few questions to verify your identity.

Activation Code Request for Others - Proxy Access


What is proxy access?

Proxy access allows a person to access data in another person's medical record. Typically, parents will use this to access their children's accounts so they can schedule appointments check immunizations, reorder medications, and coordinate other health-related information for their children. Adults may also use it to access an older parent or relative's record. This is particularly useful for helping older adults monitor medications and appointments. This communication is done using a HMH MyChart account and is restricted to non-urgent matters. Proxy access is granted once an authorization form has been completed and processed.


Submit Proxy Request Forms:

Download the appropriate form and mail it to Hackensack University Medical Center, Health Information Department, 30 Prospect Avenue, Hackensack, NJ 07601 OR Fax: 201-489-0591.


Access to Children's Records

Access to the MyChart of account of children 11 and under is automatically available to parents and legal guardians. The child's physician office can grant that access. Access to MyChart accounts of children 12-17 can be granted by filling out the HMH MyChart Teen Consent Caregiver/Proxy Form. The teen, parent and provider must review, agree and sign the consent before access is granted. Proxy access is automatically terminated on the teen's 18th birthday. The teen will still have access but the guardian (proxy) will no longer have access.


Adult-Adult Proxy

Adult-Adult proxy access allows another adult full access to the HMH MyChart account of a Hackensack Meridian Health patient who is 18 years of age or older. In order to obtain access, both the patient and proxy must complete and sign the HMH MyChart Adult Proxy Form. The proxy's access is terminated when the patient makes a written request to terminate access or revokes access from within their MyChart account.


To access the patient's chart


1. Log in to your MyChart account from our secure web page with your MyChart username and password.

2. Select the tab on the right with the patient's name.

Please feel free to contact us if you have any problems at MyChart Support.

Thank you for your interest!

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