MyUnityPoint - Sign Up

Please enter the requested demographic information to complete the identity verified process from Experian, a third party vendor. If your identity is verified, and you do not already have a MyUnityPoint account, you will be prompted to create an account. If the information you have provided does not match the information we have on file, access to your medical record could be delayed. If you have any questions, please contact our support line at 1-877-224-4430.

Please sign up one person/name at a time.

First name

Middle name

Last name

Date of birth

Email address

Verify email address

Mobile phone

Home phone

Legal sex

FemaleMaleUnknownX

By providing the information requested, I acknowledge that UnityPoint Health will receive and use this information in the event that I receive care at UnityPoint Health hospitals and clinics. I understand that until such information is used for my care, it does not constitute protected health information, as defined in the Health Insurance Portability and Accountability Act (“HIPAA”). I authorize UnityPoint Health to use any contact information provided, whether mobile phone, physical address, electronic mail or otherwise, to contact me about my health and products or services UnityPoint Health provides.

We are checking with a third-party system to verify your identity. This may take several seconds.

These questions are generated by a third-party system to verify your identity.

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Name

Address

Other Information

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Patient Information

Name

Address

Other Information

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