Proxy Access for Children and Adults | MyUnityPoint

Proxy Access

Through the MyUnityPoint website, registered users can request online access to medical information for their children or someone else in their care that has impaired decision-making abilities. Also, adult patients may grant proxy access to other adults, allowing spouses, adult children, and others to have access to an existing adult patient's account.

The type of proxy access is primarily based on the patient's age. The "proxy" is the person granted access to another person's health information. 

Proxy Access Forms

Please allow 10 business days for processing.


Proxy access for children 0 -11 years of age.

Limited Teen 

Proxy access for children 12 - 17 years of age.

Incapacitated Patient

Proxy access for patients who are unable to make their own healthcare decision.

Teen Connection

Access for patients 14 - 17 years of age, to view their own health information. This is not proxy access as the patient is accessing his/her own health information.

Adult to Adult

Proxy access for patients 18 years of age and older.

To get started with the online form, please complete the form below.

Required fields indicated by *

Patient's Date of Birth*
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