How to Fill Out and Submit the Mount Sinai Settlement Claim Form

If you had a Mount Sinai MyChart account between October 27, 2020, and October 27, 2023, you can claim a share of a $5,256,588 settlement by submitting the Mount Sinai settlement claim form online at www.mountsinaisettlement.com or by mail, postmarked by October 14, 2025.¹ The form is one page, takes a few minutes, and does not ask you to prove any financial harm.

Who Can File a Claim

The class covers roughly 1,314,147 people who held a Mount Sinai MyChart account and logged in through mychart.mountsinai.org at any point in that three-year window.² A login during the class period is the only eligibility test. You do not need to show that your information was shared with Facebook or that you lost money.

One thing to clear up: this is not a data breach case involving Social Security numbers or medical records. The lawsuit alleges Mount Sinai embedded Facebook’s Meta Pixel and Conversions API on its MyChart login pages, which transmitted browsing activity to Facebook along with identifiers like IP addresses.³ Mount Sinai denies the claims; the settlement resolves the dispute without a finding of liability.

What the Form Asks For

You can download the form from www.mountsinaisettlement.com or fill it in directly on the site. It has five short sections:⁴

Contact information: name, mailing address, email, and an optional phone number.
Eligibility certification: check the box confirming you logged into MyChart during the class period, and enter the Unique ID Number from your notice.
Payment election: check the box confirming you want a pro rata payment from the fund.
Signature: sign, date, and print your name.

There is no section for receipts, time logs, or documentation of harm. Every valid claim gets an equal share of what’s left in the fund after costs; there are no tiers.

Finding Your Unique ID Number

The Unique ID is on the settlement notice you received. If it came by email, the Class Member ID is at the top of the message.⁵ If it came by mail, it’s printed on the notice itself. Without it, the administrator cannot match your claim to the class list. If you can’t find your notice, call the settlement administrator at (833) 890-5910.

Getting Paid Electronically

To receive your payment electronically rather than by check, file through the settlement website instead of by mail. The online portal walks you through setting up the electronic transfer during the filing process.⁴

How and Where to Submit

You have two options, both with the same October 14, 2025, deadline.¹

Online at www.mountsinaisettlement.com. The site generates a confirmation when you finish; save it.
By mail to Mount Sinai Settlement, c/o Kroll Settlement Administration LLC, P.O. Box 225391, New York, NY 10150-5391. The envelope must be postmarked by October 14, 2025.⁴

Miss the deadline and your claim is barred unless the court approves it for good cause at the final approval hearing.⁶

What Happens After You File

Kroll Settlement Administration reviews each claim against the class list. If something is missing or doesn’t match, Kroll will reach out using the email address on your form. Hold on to your confirmation number and a copy of the form until your payment clears.

Payments don’t go out until after the court grants final approval at the hearing scheduled for October 24, 2025, at 2:30 p.m. ET, and any appeals are resolved.¹ The settlement agreement sets distribution at sixty days after the Effective Date, which is when approval becomes final and all appeal periods have expired.⁶ With no appeals, that points to early 2026. An appeal would push it out further.

How Much to Expect

The $5,256,588 fund has deductions before anything reaches claimants: $200,000 for settlement administration, up to 35% of the net fund (around $1.84 million) for attorneys’ fees, and service awards of up to $2,500 each for the three named plaintiffs.¹ What’s left is split equally among everyone who submits a valid claim. The per-person figure depends on how many of the 1.3 million class members actually file, so exact amounts are impossible to predict until the claims window closes.⁷

Opting Out, Objecting, or Doing Nothing

Opting out and objecting both share the October 14, 2025, postmark deadline. Opting out means mailing a written exclusion request; you get no payment, but you keep the right to sue Mount Sinai separately over the tracking allegations.¹ Objecting means filing a written objection with the court; you can still receive a payment and can ask to speak at the October 24 hearing.

Doing nothing is the worst outcome. You get no payment, and once the settlement is final you lose the right to sue Mount Sinai over the tracking claims covered by the release.¹ If you’re eligible, filing takes a few minutes and costs nothing.

1
ClassAction.org. Notice of Proposed Class Action Settlement: Cooper v. Mount Sinai Health System, Inc.
2
The HIPAA Journal. Mount Sinai Health System Settles Web Tracking Lawsuit for $5.3 Million
3
FindLaw. Cooper v. Mount Sinai Health Systems Inc.
4
ClassAction.org. Cooper v. Mount Sinai Health System, Inc. Claim Form
5
Mount Sinai Health System. Email Notice of Proposed Class Action Settlement
6
ClassAction.org. Cooper v. Mount Sinai Health System, Inc. Settlement Agreement
7
ClaimDepot. Mount Sinai Health System $5.26M Class Action Settlement