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 account of children under the age of 12 is available through what's called proxy access. The child's physician office can grant this access. Access to MyChart accounts of children from the age of 13-17 can be granted by completing the HMH MyChart Teen Consent Proxy Form. Teen, parent and provider must review, agree, and sign the consent form before access is granted. Teen proxy access is automatically terminated on the teen's 18th birthday. The teen's account will not expire on his/her 18th birthday. If the teen chooses to revoke proxy access, his/her own access will also be terminated.


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!

Return to Top

MyChart HOME