Online Access Request Form
You can gain instant access to your UR Medicine MyChart by filling out all the information below. If your identity is confirmed within our system, you can complete the final account setup steps and begin enjoying the benefits of UR Medicine MyChart. The more information that you provide increases our ability to confirm your identity; however, if you don't know/wish to answer, enter NA.
- Important: You must be 18 years and older to request access for MyChart online. If you are under 18, please speak with your doctor's office. If you are a parent, please read these instructions on how to request access to your child’s MyChart.
We need some information in order to grant you a MyChart account. Enter your demographics here and in the next step we will verify your identity using questions from a third-party verification system. Once verified, you will receive an email or a letter with your activation code and instructions on how to activate your MyChart account. If you have any questions, please contact your clinic.
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