Enrolling for MyHealth Patient Portal
Granting Medical Proxy
Patient and Guardian Proxy Access Instructions
For children younger than 12 years old, the parent and guardian should sign as both the proxy and the patient. For children 12 years and older, the child should sign as the patient. This is to comply with Illinois state and federal laws which allow minors 12 years and older to consent to treatment for particular types of services. In this case, related medical information may not be permissible to release to a parent, guardian, or proxy. The MyHealth Patient Portal does not limit particular types of information; therefore, we must abide by legal requirements of obtaining consent from both the minor patient (age 12 and older) and the proxy.
*In situations with multiple children, each child will require their own proxy form.
Requesting Paper Copies of Records
Completed forms can be submitted via mail, fax, or in person.
Mail forms to:
Health Information Management
6800 State Route 162, Suite 175
Maryville, Illinois 62062
Fax forms to:
Email forms to:
If you need assistance with your request for medical records or accessing the MyHealth Patient Portal, please call our
Health Information Management Department at 618.391.6100. Our office is open Monday – Friday from 7:30 a.m. to 4:30 p.m. (excluding major holidays).