Mychart Parent Guardian Sign Up Form Lurie Childrens Hospital

MyChart Parent/Guardian Sign Up Form - Lurie Children's Hospital.

Please provide the information requested below. Up to 3 children are allowed on this form. To sign up for proxy access to more than 3 children, please fill out and submit this form again. If your child is 12 years and older, please remember to submit a signed authorization form: MyChart Authorization Forms.

About MyChart - Lurie Children's Hospital.

Once a minor patient reaches age 18, MyChart access to the proxy account holder will be automatically revoked, and the patient may set up their own account. If the patient is 18 years of age or older and wishes for a parent or guardian to become, or remain, a proxy account holder, the patient and the proxy must complete an authorization form..

Pediatric Ophthalmologist & Eye Specialist | Lurie Children's.

Ann & Robert H. Lurie Children's Hospital of Chicago. 225 E. Chicago Ave., Chicago, Illinois 60611 ... a MyChart account will be set up for you to schedule appointments online. Make an Appointment By Phone. Please call 1.800.KIDS DOC (1.800 ... After you have completed the patient information and signed the parent or guardian consent portion of ....

Medical Records - Lurie Children's Hospital.

If you/your child are hospitalized, submit the form upon discharge to Health Information Management, located on the main hospital's 9th floor. Fax 312.227.9733 Attn: Release of Information. Mail Ann & Robert H. Lurie Children's Hospital of Chicago Health Information Management 225 East Chicago Avenue, Box 11 Chicago, IL 60611 Attn: Release of ....