mySyringaChart with Captcha

Sign Up for mySyringaChart Today!

Receive access to your medical information anywhere, any time! Simply fill in the following form to receive an email from mySyringaChart@iqhealth.com with login information. If you would like access to your children's health records online, contact the Health Information Management department at Syringa Hospital & Clinics at (208) 983-1700. Please download the mySyringaChart brochure for more information on setting up your account.
Name *

First Name Middle Name Last Name
Identity Info #1 *
Last 4 digits of Social Security Number for ID purposes
Identity Info #2 *
Date of Birth mm/dd/YYYY
E-mail *
Phone Number *

Area Code Phone Number
Type the characters you see here: *
By selecting the Submit button below, I acknowledge that Syringa Hospital & Clinics is releasing my medical records in electronic from, and that if I share an email address with others, those parties may also have access to my medical information until I establish my own secure connection, protected by a password.
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Sign Up for mySyringaChart Today!