MyChart Proxy Access for Adults with Diminished Mental Capacity

If a patient is unable to make their own medical decisions, the patient's personal representative (legal guardian, healthcare advocate or representative of the patient's estate) may be eligible for full or read-only proxy access to the patient's MyChart account. Proper supporting documentation is required.

Supporting Documentation

• Legal Guardian must provide a copy of the Court Order Appointing Guardian and Letters of Guardianship demonstrating that the scope of guardianship includes the right to authorize release of medical information or execute medical authorizations on behalf of the patient.
• Healthcare Advocate must provide a copy of the valid Durable Power of Attorney for Healthcare and two Physician Certifications verifying that the patient lacks decisional capacity.
• Representative of the Patient's Estate must provide a copy of General Power of Attorney specifically indicating that authority has been given to authorize release of medical information or execute medical authorizations on behalf of the patient.

Types of Proxy Access

Read-only proxy access enables you to view all information in the patient's MyChart account.

Full proxy access enables you to view all information and perform tasks on behalf of the patient, such as requesting appointments or prescription renewals, sending and receiving secure messages and granting or revoking proxy access.

How to Apply for Proxy Access

To apply for proxy access, complete Form EMR04140 and mail it or fax it along with supporting legal documents to:

Health Information Management
4000 Wellness Drive
Midland, Michigan 48670
Fax (989) 839-3035

Or you may take it to the participating provider's office or Medical Center where the patient receives their care.