Name: | DOB: | MRN: | PCP:

Activation Code Request

Welcome! UC Health is pleased to offer this online request service for your My UC Health activation code. Your activation code will be your key to your personal and secure electronic medical record. Please fill out all fields to verify your identity.

We will mail your activation code to the home address on file after validating your submission with your UC Health System information. Should we have any questions regarding your submission, we will contact you via the home phone number or email address you have submitted.