Enrolling Additional Children

Step 1

Fill out a physical copy of the Authorization for Participation in MyChildrensMercy Patient Portal form. You can get the form by:

• Downloading the form:
  • Authorization for Participation in MyChildrensMercy Patient Portal.
• Picking one up in person at the Adele Hall Campus Health Information Management department at 2401 Gillham Road, Kansas City, MO, 64108.
• Calling (816) 234-3455 to have a form sent by email, fax, or mail.

Important notes:

• If you are a patient over the age of 18: You will need to include a copy of a signed form of identification (like a driver's license or school ID) with the application. If you wish to give your parents access, sign the section titled Proxy Access.
• If you are a guardian of a patient over the age of 18: You will need to include a copy of legal documentation with the application stating that you are the court appointed guardian of the patient. The patient may also grant permission to you to access their account.

Step 2

You may return the form one of the following ways:

• Fax to (816) 701-4034 or
• Mail to Children's Mercy Health Information Management, 2401 Gillham Road, Kansas City, MO 64108

Step 3

• You will receive an email invitation to the patient portal when the forms are processed. You must accept the invitation.
• The email link will expire in 90 days. Please check your email to activate your access.
• Once these steps are complete, you will see the names of all enrolled children when you sign into the patient portal.