Name: | DOB: | MRN: | PCP:

Adolescent Activation Code Request

1. Complete the online sign-up form

Complete the form below to request a personal MyUofMHealth account. All information must be entered as indicated in order to successfully process your request. If the information provided does not match our records, we will contact you via e-mail or phone. Please provide a phone number that we can reach you at for any questions related to your MyUofMHealth request.

We will use e-mail only to clarify your MyUofMHealth request. We will not send any information about your health via e-mail. All the information you provide during the registration process is confidential and will be processed through secure internet servers.

2. Receive an activation code via e-mail.

Your MyUofMHealth request will be granted at the discretion of your provider/physician (Michigan Medicine). Upon validating your submission, an activation code and login instructions will be emailed to you. Please allow 7 business days.

3. Activate your account.

When you receive an Activation Code, return to MyUofMHealth.org and complete the steps provided to activate your account.

Eligibility: Request an account if you are between 11 and 17 years old.

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, call Health Information Management at 734-615-0872 Monday through Friday 7:30 am - 4:00 pm.


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Please allow 7 business days for a MyUofMHealth.org activation code and login instructions to be emailed after validating your submission. When you receive your activation code, return to this website and complete the steps to activate your account.