MyCareCompass

User Registration

Complete this form to create a new patient portal account.

Patients 18 or older can register themselves.
If you already have a MyChart account and need access to a loved one's record click here.
Children ages 13 to 17 can access their records with approval from a parent or legal guardian. The parent or legal guardian must have an active MyChart account, and must submit a family access request here.

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Asterisk (*) denotes a required field

Full Legal Name:

First Name is required

Last Name is required

Address:

Street Address is required

City is required

State is required

Zip code is required

Last four digits of Social Security Number:

Last four digits of Social Security Number is required

Sex:

Sex is required

Date of Birth:

Year is required

Email:

Email is required

Phone #:

Phone type is required

Phone # is required

Your primary organization:

Medical Record Number (Optional):

Have you been seen at your selected primary organization in the past?

Yes No