When you sign-up for My Health Home, you can Manage family members' health
records, once authorized.
Authorization can be granted by downloading a Proxy Access Request and
Authorization Form and returning it to Campbell County Health
Health and Information Services (Medical Records). The office is open Monday-Friday from 8 am-5 pm.
For more information about My Health Home, call 307-688-7878.
If you would like to access your child's records, please follow these instructions:
Definitions
Patient – your minor child (under the age of 18)
Parent – legal parent or permanent legal guardian
Under the Minor Child section, mark either Parent or Permanent Legal Guardian
Select Age Group
Provide the Parent or Permanent Legal Guardian Signature on the last page
Parent or Permanent Legal Guardian also signs for the patient who is minor
under the age of 18.
The signatures must be witnessed by someone over the age of 18.
If you would like to access your spouse or parent's records, please follow
these instructions:
Definitions
Proxy – Individual (over the age of 18) identified by the patient
who is approved by the patient to access the patient's medical records.
Patient –Individual (over the age of 18) receiving care
Under the Adult Patient section, mark Adult Capable, Adult Patient or Legal
Guardian of Adult Patient.
If you mark Legal Guardian of Adult Patient, you must provide legal documentation
to the Medical Records Staff stating legal guardianship has been granted.
Patient and Proxy sign the last page.
The signatures must be witnessed by someone over the age of 18 and the
witness may not be the patient or proxy.
For more information about My Health Home, call 307-688-7878.
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