Request Access

University of Missouri Health Care patients (or their parents/guardians) can request online access to their health information by filling out the form below.

Note: If you are unsure if you have an account or have forgotten your password, please use the Forgot password link on the HEALTHConnect login page. If you still cannot log in to your account, want to change the email address you log in with, or are having trouble creating your account, access the Support Portal for self-help and chat support. Support is also available anytime by phone at 888-443-8271.

Patient First Name

Patient Middle Initial

Patient Last Name

Patient Date of Birth

Patient Daytime Phone Number

Patient Gender

Patient Email Address

Patient Zip Code

Are you requesting access to someone else's records? (i.e. child)

Yes

Parent/Guardian Relationship

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Date of Birth

Conditions & Treatments

Doctors

Locations

Pages

Request Access