Please Identify Yourself

Step 1

If you have received an Activation Code from your clinic or hospital, please enter it with your information below. If you do not have an Activation Code, please click "SIGN UP ONLINE" on the right side of this screen.

Si usted necesita ayuda para crear su cuenta o utilizar este sitio web, por favor llámenos al 920-272-3600.

All fields are required.

MyChart Activation Code

Enter your Activation Code as it appears on your enrollment letter (your code is not case sensitive). You will not need to use this code after you complete the signup process.

xxxxx
-
xxxxx

Please enter the last 4 digits of your Social Security Number.

nnnn
Date of Birth

Enter your date of birth in the format shown, using 4 digits for the year. MyChart accounts cannot be created for patients under 12. If you are the parent/guardian, please request proxy access via your MyChart account

mm
/
dd
/
yyyy