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Patient Information
We need some information from you in order to grant you a MyHillChart account. Once you submit the requested information, and if the information you enter matches what we have on file in your medical record, you will receive an email with your activation code and instructions on how to activate your MyHillChart account.
Please note that you must be at least eighteen (18) years old to sign up for MyHillChart online. If you are under eighteen (18) years old and would like a MyHillChart account, please contact your healthcare provider for assistance.
You may only request a MyHillChart account for yourself. Hill Physicians does not allow individuals to access a family member's or another individual's health record without appropriate authorization. If you need access to another individual's MyHillChart account you may request proxy access from the individual's healthcare provider.
By submitting this form, you hereby affirm and warrant that you are the patient identified below, and that you are at least eighteen (18) years old. You understand and acknowledge that you may be subject to penalties under law for submitting false or misleading information in connection with this online request to access MyHillChart.
We need some information from you in order to grant you a MyHillChart account. Once you submit the requested information, and if the information you enter matches what we have on file in your medical record, you will receive an email with your activation code and instructions on how to activate your MyHillChart account.
Please note that you must be at least eighteen (18) years old to sign up for MyHillChart online. If you are under eighteen (18) years old and would like a MyHillChart account, please contact your healthcare provider for assistance.
You may only request a MyHillChart account for yourself. Hill Physicians does not allow individuals to access a family member's or another individual's health record without appropriate authorization. If you need access to another individual's MyHillChart account you may request proxy access from the individual's healthcare provider.
By submitting this form, you hereby affirm and warrant that you are the patient identified below, and that you are at least eighteen (18) years old. You understand and acknowledge that you may be subject to penalties under law for submitting false or misleading information in connection with this online request to access MyHillChart.
We need some information from you in order to grant you a MyHillChart account. Once you submit the requested information, and if the information you enter matches what we have on file in your medical record, you will receive an email with your activation code and instructions on how to activate your MyHillChart account.
Please note that you must be at least eighteen (18) years old to sign up for MyHillChart online. If you are under eighteen (18) years old and would like a MyHillChart account, please contact your healthcare provider for assistance.
You may only request a MyHillChart account for yourself. Hill Physicians does not allow individuals to access a family member's or another individual's health record without appropriate authorization. If you need access to another individual's MyHillChart account you may request proxy access from the individual's healthcare provider.
By submitting this form, you hereby affirm and warrant that you are the patient identified below, and that you are at least eighteen (18) years old. You understand and acknowledge that you may be subject to penalties under law for submitting false or misleading information in connection with this online request to access MyHillChart.
We need some information from you in order to grant you a MyHillChart account. Once you submit the requested information, and if the information you enter matches what we have on file in your medical record, you will receive an email with your activation code and instructions on how to activate your MyHillChart account.
Please note that you must be at least eighteen (18) years old to sign up for MyHillChart online. If you are under eighteen (18) years old and would like a MyHillChart account, please contact your healthcare provider for assistance.
You may only request a MyHillChart account for yourself. Hill Physicians does not allow individuals to access a family member's or another individual's health record without appropriate authorization. If you need access to another individual's MyHillChart account you may request proxy access from the individual's healthcare provider.
By submitting this form, you hereby affirm and warrant that you are the patient identified below, and that you are at least eighteen (18) years old. You understand and acknowledge that you may be subject to penalties under law for submitting false or misleading information in connection with this online request to access MyHillChart.
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