Medical Record Access for a Child Ages 13-17
Parents or legal guardians (and in some cases foster parents or other caregivers) can complete this form for access to a child’s medical record.
Once you have access, you can view their record in MyChart or MyChart Bedside (available during some hospital stays).
Complete the form and follow the instructions. Include a copy of legal guardian documentation or valid documentation if authorized as a foster parent or caregiver (if not already on file.)
We process requests within 3 to 5 business days of receiving the signed form. If volume is high, it may take longer.
You’ll receive an email when you’re approved.
Children ages 13 to 17 can access their own records with parent or legal guardian approval.
Requirements to access a child's record:
- Birth/adoptive parent
- Proof of legal guardianship (with valid court order)
- Foster parents (with a valid letter from a governmental agency (usually CYS) granting permission for access) or
- Authorized caregiver (with a valid Delegation of Parental Decision-Making Authority form).
- Each person requesting access must have their own account, including for MyChart Bedside.
I understand that:
- Proof of my right to have access must be in the child’s medical record.
- To use MyChart to access the child’s record, I must log in with my own username and password.
- To access the child’s record through MyChart Bedside, I must log in with my own PIN (set up with hospital staff).
- I agree to the terms and conditions.
- When the child turns 13, access will be revoked and I’ll need to apply for reauthorization.
- In an emergency, don’t use the portal.
- Access is revoked when:
- The parent, legal guardian, authorized caregiver, patient or physician submits a request or revokes access. Your healthcare organization reserves the right to revoke access at any time.
- The patient turns 18.
- Access disputes can’t be resolved.
- The child is emancipated and tells the healthcare organization.
- Communications on the patient’s behalf must be sent from their record. Alerts will be sent to the email address on file.
- If parent or legal guardian access is revoked, the child's access will also be revoked unless they’re emancipated.