Enter your information and send it to your mobile phone or tablet.

 To learn how to use this form, please read the introductory notes. Having trouble? Consult our help.

What is this page?

This page is a form that you may use to enter your information on a computer and then transfer it to My Medical on your mobile phone or tablet. If you have a large amount of text to input, use this page as a convenience rather than typing directly into the small keyboard of a mobile device.

A standalone version of My Medical for Mac computers is also available. This page not compatible with our Mac app nor is it a replacement for it. If you are looking for our Mac app, please find it here.

How do I use this page?

After filling out the fields to the right, please enter your email address below and choose "Send". An automatically generated email will be sent to you, containing your information and instructions on how to import the email contents into My Medical.

  1. You must be able to receive email on your mobile device.
  2. My Medical must be installed on the device.
  3. For this page to work properly, you must use a JavaScript-enabled web browser.

Helpful tips

  What you type on this page will be erased after the browser window is closed. It is recommended that before closing the page, you verify receipt of the email and import it to My Medical.

  It is not necessary to enter your entire medical history all at once. You may enter as little or much as you wish at any one time, and then revisit this page to enter more. Although the page is blank each time you visit, existing information on your device will not be overwritten. When new information is imported to My Medical, the app will ask if you wish to add that information to an existing record, or create another record out of that new information alone.

  When entering dates we suggest using the calendar by clicking the calendar icon next to each field (shown at right). You can also enter dates and times by typing directly into the field instead of using the calendar. Dates and times must be written in a conventional format such as "January 31, 2012 5:45 PM" or "1/31/12 10:00 AM".

Security notes

  No information you supply on this webpage is kept on our servers. It is sent directly to the email address provided and is deleted when your session is finished.

  This page is offered as an anonymous service free for all users of My Medical, and you do not need a login or username to make use of the page. The reason is that the information you supply is not saved and is not associated with your name or personal information. The form is merely a means to temporarily transfer data to your mobile device, where it is securely stored.

  This website employs an industry standard 256-bit SSL certificate which encrypts all information moving to and from the website. An SSL certificate verifies that your information is kept safe from interception. To ensure that your connection to the website is secure, look for the "https://" prefix or a padlock icon (example shown at right) in your browser's address bar.

  • General Information
  • Medications
  • Past Medications
  • Prescriptions
  • Dietary Supplements
  • Allergies
  • Immunizations
  • Surgeries
  • Diagnoses
  • Episodes & Injuries
  • Hospitalizations
  • Physicians
  • Office Visits
  • Family History
  • Emergency Contacts
  • Health Insurance
  • Eyesight
  • Advance Directives
  • Test Results
  • Blood Glucose
  • Blood Pressure
  • BMP
  • Bone Density
  • CHEM-7
  • Cholesterol
  • CMP
  • Colonoscopy
  • Complete Blood Count
  • CT Scan
  • EEG
  • EKG
  • Endoscopy
  • Ferritin
  • Height
  • Hemoglobin A1c
  • Immunoglobulins
  • Liver Function
  • Kidney Function
  • Mammogram
  • MRI
  • PET
  • Prothrombin Time
  • PSA
  • Spirometry
  • Temperature
  • Thyroid Function
  • TIBC
  • Ultrasound
  • Complete Urinalysis
  • Routine Urinalysis
  • Weight
  • X-ray


Please provide your email address and then hit the send button. An email containing a link to upload your information will be sent to this address. Send to multiple addresses by separating them with commas.