How to Request Proxy Access for a Family Member
Submit one authorization form for each designated proxy representative (spouse, adult child, care giver, partner, legal guardian, conservator) and patient. Patients may have one proxy representative. The same person can serve as a representative for more than one patient (e.g., two elderly parents).
Fax the forms to (877) 607-6484 or
Patient Services Contact Center
ATTN: My Health Online Proxy
P.O. Box 255386
Sacramento, CA 95865-5386