MyChart - Sign Up Online

Complete this form, and then allow three business days for us to review your request. When approved, you will get an e-mail with instructions to finish setting up your account.

If you have any questions, please contact MyAtriumHealth Support toll-free during business hours at 855-799-0044.

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We need some information in order to grant you a MyChart account. Enter your demographics here and in the next step we will verify your identity using questions from a third-party verification system. Once verified, you will receive an email or a letter with your activation code and instructions on how to activate your MyChart account. If you have any questions, please contact your clinic.

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First name

Middle name

Last name

All Address fields are required.

Address

City

State

Zip

County

Country

Address	City	State	Zip	County	Country
__Street__	__City__	__State.Title__	__Zip__	__County.Title__	__Country.Title__

Please enter either your MRN or the last four digits of your SSN. This information will be used to verify your identity.

Date of birth

MM/DD/YYYY

Home phone

NNN-NNN-NNNN

Last four digits of SSN

NNNN

Email address

Verify email address

Medical record number

This field is machine-generated content. Please ignore.

Sign Up Online

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