Site Contact Update If the individual requires access / changes to their eChart Manitoba account, please submit a completed eChart Manitoba Account and Access Request form. To ensure your submission is accepted, please avoid using any special characters in the form below, such as: ! ‘ # $ % ^ & * ( ) ?, etc. Submitter Name Submitter Email Address eChart Site Name Individual InformationWho is this update for? Existing Individual New Individual Name First Last Email PhoneSite Contact Role(s)(select all that apply) All Roles Assigned Currently Authorized Account Requestor Authorized Sponsor IT Resource Outage Contact Privacy Designate Authorized Sponsor automatically receives monthly reports. Please indicate in the Comments section if you would like a copy of the reports sent to your Authorized Account Requestor or Privacy Designate. Please see the Site contact roles for eChart Manitoba that provide detailed responsibilities for some of the eChart site contact roles.CommentsAuthorization: Submitting this form confirms that the individual has been authorized by the site Authorized Sponsor to fulfill the responsibilities and includes communicating with eChart Manitoba.