If you are 18 or older, register to access your medical records
by completing and submitting the form below.
Please complete each form field.
Terms and Conditions:
I understand My Page is intended as a secure online source of confidential information. I also understand that, while Pathways has made reasonable efforts to maintain the security of the source, as with all online information, the security of the source cannot be guaranteed.
I agree that I will not share my user ID and password with anyone else. I understand that, if I give my user ID and password to anyone else, they will be able to access my information and my information will not be secure. I also confirm that I am the only one with access to the email address that I am using for the source and that email is secure. I understand that use of "My Page" is entirely voluntary and I am not required to use it.
I understand that this consent will remain in effect until I provide Pathways with a written request for revocation.
I hereby affirm that I am the client identified above. I understand that I may be subject to penalties by law for submitting false or misleading information related to this application for "My Page".
I understand the information I provide on this form is used only to confirm my identity. Updates to this information will not be made in my medical record.
By clicking submit below, I acknowledge that I have read and understand this and the "My Page" Terms and Conditions and I agree to the Terms and Conditions.
Using the email address submitted on this form, we will email your user ID and log-in password after validating your registration information. Allow sufficient time for the validation to occur. If we have any questions we will contact you either by phone or email.