Self-Enrollment for Midwest Health Connect

Self enrollment is available for Midwest Medical Center patients who are age 18 or older that don't currently have access to Midwest Health Connect, an online portal where you can view your medical information and connect with your health care team. Complete the form below to start the self enrollment process.

If you manage the health of a patient, talk to the patient's health care provider at their next visit to receive a personal invitation to Midwest Health Connect. Self enrollment is not currently available for caregivers and guardians.

* Indicates a required field.

First name

Last name

Date of birth

Month

Day

Year

Enter the year as 4 digits.

How would you like to verify your account?

What is your Social Security Number (SSN)?

Identity verification