Please fill out all the information below to gain instant access to your MyUofMHealth.org account. Based on the information provided on this form, we will match your information within the system. 

Please note that the items marked with an asterisk are "required" for matching purposes. However, if you do not know/wish to answer, leave it blank for items that are not required or enter NA for items that are marked required.

No Middle Name? If you do not have a middle name, type “none” in the field.

Medical Record Number (MRN): Each patient has a unique MRN. Your MRN must be entered using 9 digits. If your MRN is less than 9 digits, add zeros to the beginning of the number. (Example: 123456 is entered as 000123456). Locate your MRN on your blue registration card (listed as CPI number), Summary of Care note (listed in the upper left corner) given to you following your appointment, or on label stickers on most medical information from your doctor. Your MRN is NOT the same as the account number that appears on your billing statements. If you cannot locate your MRN, contact Patient Portal Support at 734-615-0872 between 7:00 am - 7:00 pm, Monday through Friday or 8:00am 1:00pm, on Saturday.

Important: You must be 18 years and older to request access online. If you are under 11, a request will be sent to HIE Support Desk for additional verfication. Patients between the ages of 11 and 17 must request a MyUofMHealth.org account through their provider.

We need some information in order to grant you a MyUofMHealth account. Enter your demographics here and in the next step we will verify your identity using questions from a third-party verification system. When you're approved, you will receive an email or a letter with your activation code and instructions on how to activate your MyUofMHealth account. If you have any questions, please contact your clinic.

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First, we need to collect some information about the patient. If you have any questions, please contact us at (734) 615-0872.

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Now, we need to collect some information about you. After you submit the request, we will set up your appointment. If you have any questions, please contact us at (734) 615-0872.

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We need to collect some information about the patient in order to schedule this appointment. If you have any questions, please contact your clinic.