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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 701.780.6500.

Follow these steps to sign up for a MyChart account.

Enter your personal information.
Verify your contact information.
Choose a username and password.

If you have any questions, please contact us at 701.780.6500.

This form should only be completed if you are requesting your own MyChart account. A patient must be at least 14 years of age to create a MyChart account. To gain access to another patient's MyChart account, please submit the Proxy Request Form. A proxy request can also be submitted electronically for your child if you already have your own MyChart account by clicking here (you will need to login to complete the form).

Follow these steps to sign up for a MyChart account:

Enter your personal information. (Please include your medical record number if known.)

Verify your contact information.

Choose a username and password.

If you have any questions, please contact us at 701.780.6500.

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A patient must be at least 14 years of age to create a MyChart account.
If the patient is under the age of 14, you will need to request proxy access to the child. Proxy request can be submitted by the Proxy Request Form or it can be submitted electronically by the parent/guardian logging into their MyChart account, MyChart Menu, scrolling down to "Proxy Access" heading, and selecting "Request Minor Proxy Access".

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Name

First name

Middle name

Last name

Address

Other information

Date of birth

Legal sex

FemaleMaleUnknown

Medical record number

What is a medical record number?This is the number assigned to you when you registered in the clinic. This number helps staff in the clinics to quickly identify your medical record. If you do not know your medical record number, you may call the registration desk.

Last four digits of SSN

Email address

Verify email address

Mobile phone

Home phone

Have an Activation Code?
Create Your Account

Need access to a family member's record?
Proxy Access Form

Thank you - your request has been sent to the clinic. You will receive an activation code in your mail or email within a week.

If you have any questions or if you do not receive your activation code, call customer service.

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We were unable to verify your information. Your request is being reviewed by support staff and you will be sent activation information in the near future. If you have any questions or concerns, please contact us at 701.780.6500.

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We are experiencing technical difficulties at this time. Please try again later or contact our customer service line for assistance.

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We were unable to verify your identity using the information provided. Please contact customer service at 701.780.6500 for assistance.

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We are experiencing technical difficulties at this time. Please contact our customer service line for assistance.

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There is an existing account for this person.

From the login page, click "Forgot username?" or "Forgot password?" to access this account.

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There is an existing account for this person.

Please contact us directly to restore access to your account.

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Ask the patient to resend the invitation.

We are experiencing technical difficulties at this time. Please try again or contact our customer service line for assistance.

Unable to complete MyChart signup. Please contact customer service at 701.780.6500 for help activating your account.

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In order to grant you a MyChart account, we will verify your identity using questions from a third-party verification system. Once verified, you will be able to create your MyChart account. If you have any questions, please contact us at 701-780-6500.

We are checking with a third-party system to verify your identity. This may take several seconds.

Unable to Verify Your Identity

We are unable to verify your identity using the information provided. Please contact us at 701-780-6500 for assistance.

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Unable to Verify Your Identity

We are experiencing some technical difficulties while communicating with the third-party verification system. Please contact us at 701-780-6500.

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These questions are generated by a third-party system to verify your identity.

How would you like to verify your identity?

You can use a third-party verification system to verify your identity now and save time at the clinic later.

Select Skip third-party verification to verify your identity at your next appointment. You'll still need to confirm your contact information using a one-time code on the next page.

You will be redirected in a few seconds.

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Patient information

Name

Address

Other information

Have an Activation Code? Create Your Account

Need access to a family member's record? Proxy Access Form

Unable to Verify Your Identity

Unable to Verify Your Identity

How would you like to verify your identity?

Have an Activation Code?
Create Your Account

Need access to a family member's record?
Proxy Access Form