How to upload an authorization form as a patient

To upload your authorization as a patient, sign in to ChartRequest. Create a new request by clicking “Requests” in the “Dashboard” sidebar or navigate to your draft by clicking the “Records & Forms” sidebar. You can either electronically sign our form by clicking “Patient e-Authorization” or upload your authorization in a PDF file by clicking “General Release.”

If you choose to e-sign your authorization, you will need to fill out your full name, initials, date of birth, and specify whether you are signing for yourself or on behalf of the requestor. Social Security number is optional. Once finished, click “Accept and Sign.”

If you would rather submit an existing authorization, either drag and drop the PDF file from your computer or click “Browse For A File” and select it via your file explorer.