Welcome to the Methodist Care Link Account Request page. To request an account, complete the fields below and click the Submit/View Form button. Please print, sign and fax the completed form to (219) 736-4013.
   * All fields required  
   Requester's Info:  
  Middle Initial/Name:
  Job Title:
  Business Email:
  Security Code: Last 4 digit of SSN   Date of Birth(mm/dd/yyyy)   
  Company Name:
  Have you ever had an Epic Id with Methodist Hospitals?  Yes No  

For assistance, please call (219) 886-5000. Thank you.