Proxy Access Forms


Forms for Proxy Access
  • Adult Proxy - Adults can access the online medical record with the patient's consent.

  • Caregiver Proxy - Caregivers can access the online medical record of a patient if the patient authorizes.

  • Child Proxy (Electronic) - You must log into MyTowerHealth for this form. Birth parents or legal guardians can access the online medical record for their children who are under 13 years old.

  • Child Proxy - Birth parents or legal guardians can access the online medical record for their children who are under 13 years old.

  • Teen Proxy - For children who are 13-17 years old, a birth parent or legal guardian can access the online medical record with the child’s consent. Children 13-17 years old can access their own online record without the consent of a parent or legal guardian.

  • Power of Attorney Proxy - Caregivers can access the online medical record of a patient if the patient authorizes. In the case of Power of Attorney (POA), the caregiver can gain access by providing appropriate Medical POA documentation.