MyChart - Signup

Welcome to the Kettering Health MyChart account registration form. Please provide all information as required below to grant you access to your personal Kettering Health MyChart account. Once approved, you will be prompted to create a username and password to complete the activation process.

Before you continue ...

Have you have previously activated your MyChart account and do not remember your username or password? You may recover your username or password by clicking the links below or calling the Kettering MyChart help desk at (937) 384-4893 or (513) 867-6493. Forgot MyChart Username | Forgot Password

Are you requesting MyChart access for a family member? Requesting MyChart access on behalf of another adult or minor family member is not permitted through this method. As a family member or parent/guardian, you may contact the patient’s doctor’s office or hospital registration to request Proxy Access to their MyChart account. To learn more about Proxy Access, click here.

We need some information in order to grant you a MyChart account. Enter your demographics here and in the next step we will verify your identity using questions from a third-party verification system. Once verified, 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 your clinic.

Indicates a required field

Name

First name

Middle name

Last name

Address

Address information is required.

AddressCityStateZIPCountyCountry

Address	City	State	ZIP	County	Country
__Street__	__City__	__State.Title__	__Zip__	__County.Title__	__Country.Title__

Other Information

Date of birth

MM/DD/YYYY

Last four digits of SSN

NNNN

Home phone

NNN-NNN-NNNN

Email address

Verify email address

Finally, as a spam prevention measure, complete the CAPTCHA below.

This field is machine-generated content. Please ignore.

I hereby affirm that I am the patient identified above, am at least 18 years old, and am requesting access to my own Protected Health Information. I understand that this grants me access only to information directly associated with my personal medical record. I may be subject to penalties under law for submitting false or misleading information related to this access to MyChart.

If the submitted information does not match your KHN electronic medical record, you will receive an email with further instructions to complete the activation process. By submitting this information, you grant KHN permission to contact you by email for this specific purpose. Your information will not be used nor shared without your consent.

MyChart Account Registration

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