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Medical Record Access for a Child Under 13

Parents or legal guardians (and in some cases foster parents or other caregivers) can complete this form to access 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.

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 13. (Access can be reauthorized.)
    • 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.
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