Welcome to MemorialCare Medical Group. For your convenience, please print and fill out all applicable forms and present them to the front desk when you arrive for your first office visit.
myChart Proxy Access
Proxy access allows
parents, legal guardians and caregivers to log into their personal myChart accounts, and then connect to medical information for the patient they represent. Available access is based on age of the patient and proper authorization.
With Partial Access, proxies can:
See most of what patient can view, excluding information related to sensitive topics and communicate with the doctor’s office.
Proxies do not have the ability to:
Request prescription refills or view appointments.
With Full Access
proxies can enjoy the same features and benefits available to the patient including access test results, Communicate with the doctor’s office, manage appointments and request prescription refills.
Advance Health Care Directive
MemorialCare Medical Group/MemorialCare recommend completing an Advance Directive/Medical Power of Attorney/Living Will/Physician Order for Life-Sustaining Treatment (POLST) form on file in your medical record. See Palliative Care & Planning for more information.
Use these forms to obtain your records from MemorialCare, or to have them sent to MemorialCare from another health provider.
- Authorization for Release of Medical Records - MCMG - English
- Authorization for Release of Medical Records - MCMG - Spanish
Use this form to opt-out of the MemorialCare Health Information Exchange
If you have any questions or you need more information, please contact our Medical Records Department at (714) 665-1647 or by FAX at (714) 665-1644.