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Please Identify Yourself

Step 1 of 3 All fields are required.
If you are not the patient, but a family member or caregiver who needs access to this chart, please complete the proxy access form: adult|| child. Please do not use the patient’s activation code. For more information see MyChart Proxy Access. Please submit via fax to 203-688-8155 or email a scanned completed copy to MyChart.eHIM@ynhh.org



MyChart Activation Code
xxxxx
-
xxxxx
-
xxxxx
 

Enter your Activation Code as it appears on your enrollment letter (your code is not case sensitive). You will not need to use this code after you complete the signup process.

Date of Birth
mm
/
dd
/
yyyy

Enter your date of birth in the format shown, using 4 digits for the year.

No Activation Code?
Request Access Code
If you have any problems email
MyChartSupport@ynhh.org
for assistance