Request MyChart Access to your Child's Record

Thank you for your interest in Seattle Children's MyChart, a free application where you can access your medical record. Learn More

This form is for a legal guardian of a Seattle Children’s patient to request access to the child’s information via MyChart (proxy access). In order to complete your request, it is required that we have legal documentation on file that the requesting person is a legal guardian. We are not able to grant access to anyone outside of legal guardians.

• If you are the parent or legal guardian of a Seattle Children's patient under the age of 18, complete Request MyChart Access to your Child's Record.
• If you are a Seattle Children's patient over the age of 18 requesting access to your own record, complete Request MyChart Access to Your Record.

If you would like access to more than one patient, please complete this form for each patient.

We will contact you if we have questions. Please note to check your email account’s spam folder.