Requesting Access to Another Patient's Account

To request access to a patient's UVM Health Network MyChart account, you will need to submit an authorization form based on the age of the patient.

Questions about proxy access? Check out our frequently asked questions.

Patients Under 12

To make sure all patient information is private and protected, parents and legal guardians must request proxy access to their child’s MyChart account. A proxy is a person allowed access to another person’s MyChart account.

To request proxy access, you must:

  1. Have your own MyChart account. If you do not have a MyChart account, you can sign up online or ask for an account during a visit.
  2. Complete and submit the MyChart Proxy Access Request & Authorization form for a child under 12 years old.
    • Online: Complete and submit the form online within MyChart.
    • In Print: Download the form below, and then return the completed form to the location where your child receives care. You may also mail it to that location’s Health Information Management office; see mailing addresses below.

Online Form Download Form

Patients 12 to 17

Parents or legal guardians who manage the medical care of an adolescent age 12 to 17 can request access to the patient's online medical record. The patient must give their consent and can choose to grant limited or full proxy access. Please read the FAQs below for more information regarding proxy access for patients ages 12 to 17.

To request proxy access, you must:

  1. Have your own MyChart account. If you do not have a MyChart account, you can sign up online or ask for an account during a visit.
  2. Download and complete the MyChart Proxy Access Request & Authorization form for a child between 12 and 17 years old. The patient must also sign this form.
  3. Return the completed form to the location where the patient receives care. You may also mail it to that location’s Health Information Management office; see mailing addresses below. Online submission is not available.

Download Form

Patients 18 or Older

Adults who manage the medical care of another person who is 18 or older can request access to the patient's online medical record. The patient or their legal representative must give their consent.

To request proxy access, you must:

  1. Have your own MyChart account. If you do not have a MyChart account, you can sign up online or ask for an account during a visit.
  2. Download and complete the MyChart Proxy Authorization Form for an adult 18 or older. The patient or legal representative must also sign this form.
  3. Return the completed form to the location where the patient receives care. You may also mail it to that location's Health Information Management office; see mailing addresses below. Online submission is not available.

Download Form

Submitting a Proxy Application Form

At the Point of Care

Completed forms may be taken to the location where the patient receives their care.

By Mail

Completed forms may be mailed to the Health Information Management office at the hospital where the patient receives their care.

UVM Medical Center
HIM -  Holly Court
111 Colchester Avenue
Burlington, VT 05401

For proxy access for patients who receive care at UVM Medical Center, you may also email completed forms to MyChartProxyatUVMHealth [dot] org (MyChartProxy[at]UVMHealth[dot]org). You will receive a confirmation email once the proxy application is processed. We will contact you regarding any questions or issues.

Central Vermont Medical Center
Health Information Management
PO Box 547
Barre, VT 05641

Champlain Valley Physicians Hospital
Health Information Management
75 Beekman Street
Plattsburgh, NY 12901

Elizabethtown Community Hospital
8 Williams Street
Elizabethtown, NY 12932

Alice Hyde Medical Center
133 Park Street
Malone, NY 12953

Porter Medical Center
Health Information Management Services
115 Porter Drive
Middlebury, VT 05753

Frequently Asked Questions

A proxy is a person who has been granted access to another patient's MyChart account. 

If you are a spouse, caregiver, or parent who needs access to another patient's MyChart account, you must first have your own MyChart account and then request to become a proxy. Visit UVMHealth.org/MyChartSignUp to sign up. A proxy is a person who has been granted access to another patient's MyChart account. 

To request proxy access, you will need to complete the appropriate UVM Health Network MyChart Proxy Access Authorization Form, as outlined above, and return the completed form to the location where the patient receives care. You may also mail the completed form to that location's Health Information Management office. See mailing addresses above.

Which proxy request form you need depends on the age of the patient.

  • Patients ages 11 and younger: If you are seeking proxy access for a child under age 12, you must be either a birth parent or legal guardian, or you must have permission from a parent or legal guardian.
  • Patients ages 12 to 17: If you are seeking proxy access for a patient who is 12 to 17 years old, the patient must sign the form and select the type of proxy access: Full or Limited. Parents and teens should discuss these options with the teen’s provider.
  • Patients ages 18 and older: If you are seeking proxy access for an adult patient who is 18 years old or older, the patient or their legal representative must give their consent and sign the form.

Proxies can view any medical information available in MyChart. This includes upcoming visit details, After Visit Summaries, visit notes, health summaries, current medications, health alerts and reminders, test results, and care team messages. If there is sensitive information in your record, such as mental health care, substance use disorder, or sexually transmitted disease, that information may be included. Patients should only provide proxy access if they authorize their proxy to view all of their information. Only patients ages 12 to 17 can choose a limited view for their proxies.

Patients ages 12 to 17 can choose to give their proxies limited access, thus restricting information visible by the proxy.

Parents and guardians make most medical decisions for their children. However, adolescents are legally entitled to privacy when it comes to certain health decisions and information. This includes information presented in their MyChart account. Health care privacy allows adolescents to practice independence and learn to manage their health as they transition to adulthood. Teens can also discuss health concerns they may feel self-conscious about directly with a provider. As a parent or guardian to an adolescent age 12 or older, you play a critical role in their health, well-being and medical care. We encourage you to help your child sign up for their MyChart account and discuss what proxy access means for both of you.

If you have further questions, please speak with a member of your or your child’s care team. We’re happy to help!

When your child turns 12 years old, they are able to sign up for their own MyChart account. At this time, your access to their account also becomes limited unless they authorize full access. If your child wants to give you full access to their account, they must complete and sign the MyChart Proxy Access Request & Authorization form before it is submitted in person or by mail.

If you have further questions, please speak with a member of your or your child’s care team. We’re happy to help!

It depends on the age of the patient. 

  • Patients ages 11 and younger: Proxy access lasts until the patient turns 12, at which time it will convert to limited access. Patients may choose to grant full access. Proxies will be notified prior to this date. 
  • Patients ages 12-17: Proxy access lasts until the patient turns 18 or revokes or changes the type of access. 
  • Patients 18 and older: Proxy access lasts until the patient revokes access.

You can remove someone's access to your medical information in two ways. First, you can call your provider's office and ask them to remove a person's proxy access. Or, if you have your own UVM Health Network MyChart account, login and navigate to the Profile section in the top toolbar and click on Family Access Settings. On this page, you can click and remove people in the ‘People who can view my account' section.