My UKHealthCare Proxy Accounts

For minor children and dependent adults

If you are the personal representative (ex. parent, legal guardian, attorney-in-fact) of a UK HealthCare patient, you can complete this form to request “proxy access” to the patient’s health information in the My UKHealthCare patient portal.

Note: Due to state and federal privacy laws, no new updates will be added to the accounts of patient age 12-18, although information up through age 12 will be available. On the patient’s 18th birthday all proxy access will end; the patient may request their own access at that time.

To request proxy access, print this form, fill it out. Options for returning the form to us are listed at the bottom. Note that proxy access is granted strictly at the discretion of UK HealthCare and may be revoked at any time. 

You must complete a separate form for each patient for whom you are requesting proxy access. Once we receive your email address, look for an email from “Follow My Health.” Follow the easy 1-2-3 directions in the email to set up an account.

Download and print the proxy application form (PDF, 60 KB)

If you have any questions, please visit or call our Health Information Management office.

Page last updated: 5/8/2015 12:00:48 PM