MyChart - Sign Up

We need some information from you in order to grant you a MyLeon Chart account please complete the form below. Once you have completed this form and you have created a user name and password proceed to the main page and from the Menu click “Insurance Summary” to add your insurance information. You can also upload a copy of your insurance card.

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 305-642-5366.

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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 305-642-5366.

Indicates a required field

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 305-642-5366.

Indicates a required field

First, we need to collect some information about the patient. If you have any questions, please contact us at 305-642-5366.

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Now, we need to collect some information about you. After you submit the request, we will set up your appointment. If you have any questions, please contact us at 305-642-5366.

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We need to collect some information about the patient in order to schedule this appointment. If you have any questions, please contact your clinic.

First name

Middle name

Last name

Date of birth

Email address

Verify email address

Social Security number

Legal Sex

Female Male Unknown Other

Home phone

Mobile phone

Sign Up

Name

Address

Other Information