Complete the form below to request an Activation Code mailed to your home.
This account will connect to your information in the records of
- UW Health (University of Wisconsin),
- SwedishAmerican,
- Access Community Health Centers
- and Quartz
Parents & Guardians: To request access to your child or another person, log into your personal account and follow the instructions to request proxy access.
Please read the MyChart Terms and Conditions of Use. You may also learn more on the FAQs page.
If the information you provide does not match our records, we will contact you for clarification at the email address you provide below. Please note that most email is not encrypted, and therefore not absolutely private. We will not send any information about your health to the email address below.
Indicates a required field,
This account will connect to your information in the records of
- UW Health (University of Wisconsin),
- SwedishAmerican,
- Access Community Health Centers
- and Quartz
Parents & Guardians: To request access to your child or another person, log into your personal account and follow the instructions to request proxy access.
If the information you provide does not match our records, we will contact you for clarification at the email address you provide below. Please note that most email is not encrypted, and therefore not absolutely private. We will not send any information about your health to the email address below.
Indicates a required field
First, we need to collect some information about the patient. If you have any questions, please contact us at 1-877-768-0732.
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Now, we need to collect some information about you. After you submit the request, we will set up your appointment. If you have any questions, please contact us at 1-877-768-0732.
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We need to collect some information about the patient in order to schedule this appointment. If you have any questions, please contact your clinic.
