Proxy Access for Children and Adults | MyUnityPoint

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

To get started, please complete the form at the bottom of the page. Please allow 10 business days for processing.

Pediatric (Ages 0-11 Years)

Limited Teen (Ages 12-17 Years)

Teen Connection (Ages 14-17)

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

Adult to Adult (Over 18 Years)

Incapacitated Patient

Incapacitated proxy access is for caregivers of patients who are unable to make their own healthcare decisions.


Get Started

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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