WGH MyChart - Sign Up

Do not use this form to request access to a family member’s chart. Once you have established an account, log in and visit "Request Family Access" for more information.

Improperly obtaining access to another's medical records without a valid patient authorization is against State and Federal confidentiality law and is subject to fines and/or imprisonment.

Please call 618-263-6424 if you have questions.

Follow these steps to sign up for a WGH MyChart account.

Enter your personal information.
Verify your identity.
Choose a username and password.

If you have any questions, please contact us at (555) 555-5555.

Follow these steps to sign up for a WGH MyChart account.

Enter your personal information.
Verify your identity.
Choose a username and password.

If you have any questions, please contact us at (555) 555-5555.

First, we need to collect some information about the patient. If you have any questions, please contact us at 618-263-6424.

Indicates a required field

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 618-263-6424.

Indicates a required field

First name

Middle name

Last name

Date of birth

Legal sex

Female Male Unknown

Home phone

Mobile phone

Email address

Verify email address

Last four digits of SSN

Sign Up

Name

Address

Other Information

Sign Up

Patient Information

Name

Address

Other Information