MyChart - Sign Up

This form is for self-signup only. If you are seeking access to a minor's record please call 940-764-HELP (4357) for instruction.

We need some information from you in order to grant you a MyChart account. Most often access will be granted immediately. If access cannot be granted immediately, you will receive an email with your activation code and instructions on how to activate your MyChart account. If you have any questions, please contact our MyChart team at MyChart@UnitedRegional.org or 940-764-HELP (4357).

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Follow these steps to sign up for a MyChart account.

Enter your personal information.

Verify your contact information.

Choose a username and password.

If you have any questions, please contact us at 940-764-4357.

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Follow these steps to sign up for a MyChart account.

Enter your personal information.

Verify your identity.

Choose a username and password.

If you have any questions, please contact us at 940-764-4357.

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Follow these steps to sign up for a MyChart account.

Enter your personal information.

Verify your identity.

Choose a username and password.

If you have any questions, please contact us at 940-764-4357.

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First, we need to collect some information about the patient. If you have any questions, please contact us at 940-764-4357.

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Now, we need to collect some information about you. After you submit the request, we will set up your appointment. If you have any questions, please contact us at 940-764-4357.

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We need to collect some information about the patient in order to schedule this appointment. If you have any questions, please contact your clinic.

First name

Middle name

Last name

Date of birth

Legal Sex

Female Male Unknown

Last four digits of SSN

Email address

Verify email address

Home phone

Sign Up

Name

Address

Other Information