MyChart - Sign Up

We need some information from you in order to set up a MyChart account. Once submitted, provided the information you enter below matches the information we have on file, you will receive an email prompting you to begin the set up process. If the personal information you enter does not match what is on record at The Christ Hospital you will receive an email with instructions on how to activate your MyChart account. If you have any questions, please contact your providers office.

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Follow these steps to sign up for a MyChart account.

Enter your personal information.
Verify your identity.
Choose a username and password.

If you have any questions, please contact us at (555) 555-5555.

Follow these steps to sign up for a MyChart account.

Enter your personal information.
Verify your identity.
Choose a username and password.

If you have any questions, please contact us at (555) 555-5555.

We need to collect some information about the patient in order to schedule this appointment. If you have any questions, please contact your clinic. Your social security # is highly recommended to match your identity and to verify your insurance.

First name

Middle name

Last name

Date of birth

Legal sex

Female Male Unknown Nonbinary X Other

Home phone

Email address

Verify email address

Last four digits of SSN

Mobile phone

Medical record number

Sign Up

Name

Address

Other information

Sign Up

Patient information

Name

Address

Other information