MyChart - Sign Up

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 909-478-5160.

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 909-478-5160.

Follow these steps to sign up for a MyChart account.

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

If you have any questions, please contact us at 909-478-5160.

Follow these steps to sign up for a MyChart account.

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

If you have any questions, please contact us at 909-478-5160.

First name

Middle name

Last name

Date of birth

Legal sex

Female Male Unknown Nonbinary X

Email address

Verify email address

Home phone

Mobile phone

Last four digits of SSN

Sign Up

Name

Address

Other information

Sign Up

Patient information

Name

Address

Other information