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Activation Code Request

Welcome! Henry Ford is pleased to offer this secure online request service for your Henry Ford MyChart activation code. Your activation code will be your key to your personal and secure electronic medical record.

Please fill out all fields, as they are required.

Activation codes are only necessary for patients who are brand new to the Henry Ford MyChart. If you know, or think, you might already have an active Henry Ford MyChart and you are currently unable to successfully log in then please contact us at 1-800-436-7936 (800-HenryFord) and select option two in order to connect with a Henry Ford MyChart advocate. They will be able to reset access to your account and provide log in information from 7:00 a.m. to 5:30 p.m. Monday through Friday. If it is outside our business hours, or if you would just prefer to communicate with us online, then you can also send us message at and we will respond as soon as we receive your message. Please include your name and either your medical record number or date of birth in your message along with your question or request. If you would prefer us to call you, then you can send us an e-mail with your name, phone number, and reason for contacting us in the message included, and we will call you.

If the patient is a minor (age 0-13) or dependent, you will not be able to request access to their account through this form. MyChart offers 'Proxy Permission' where a parent or legal guardian may have one login account to MyChart and can be granted access to view their dependent's information. In order to request proxy permission you will need to visit a Henry Ford location or complete an online request through your MyChart account. The Henry Ford staff will then complete the proper verification to grant the permission. This process is for the security of the patient's information.

We will mail your activation code to the home address on file within our registration system after validating your submission with your Henry Ford patient record information. If we have any questions regarding your submission, or find discrepancies between the data entered here and what is on our registration system, we will contact you via the phone number or the email address you have submitted, prior to sending an activation code. If all information entered online exactly matches our registration system, your activation code may be emailed to you.