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Patient information
We need some information to grant you a MyChart account. After you submit this request, it may take up to a week for processing and verification. When you're approved, you will receive an email or a letter with your activation code and instructions on how to activate your MyChart account. If you have any questions, please contact us at 1-774-261-1292.
Complete the form below to sign up for MyChart. Fields marked with an asterisk (*) are required. If the information you enter matches our records, you can activate your account immediately. If we need to verify your information, we'll review your request and contact you within 5 business days.
Who can use this form?
- Adults age 18 and older can create their own MyChart account online.
- To manage a child’s account or another adult’s account, please contact Reliant Medical Group at 1-508-425-5857.
Already have an account?
If you've forgotten your MyChart username or password, return to the login page and select Forgot login information.
Need help?
Contact the MyChart Support Team:
Complete the form below to sign up for MyChart. Fields marked with an asterisk (*) are required. If the information you enter matches our records, you can activate your account immediately. If we need to verify your information, we'll review your request and contact you within 5 business days.
Who can use this form?
- Adults age 18 and older can create their own MyChart account online.
- To manage a child’s account or another adult’s account, please contact Reliant Medical Group at 1-508-425-5857.
Already have an account?
If you've forgotten your MyChart username or password, return to the login page and select Forgot login information.
Need help?
Contact the MyChart Support Team:
Complete the form below to sign up for MyChart. Fields marked with an asterisk (*) are required. If the information you enter matches our records, you can activate your account immediately. If we need to verify your information, we'll review your request and contact you within 5 business days.
Who can use this form?
- Adults age 18 and older can create their own MyChart account online.
- To manage a child’s account or another adult’s account, please contact Reliant Medical Group at 1-508-425-5857.
Already have an account?
If you've forgotten your MyChart username or password, return to the login page and select Forgot login information.
Need help?
Contact the MyChart Support Team:
Complete the missing information below to finish signing up for a MyChart account.
If you have any questions, please contact us at 1-774-261-1292.
Enter your personal information to sign up for a MyChart account.
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