MyChart -

As a parent or legal guardian, you can access your child's medical records on MyChart through proxy access. Proxy access allows you to keep track of vaccination records, growth charts, diagnoses and medical instructions, as well as communicate with your child's UChicago Medicine health care providers.

You must have parental rights or legal guardianship to receive access to your child's MyChart account. By reading, completing and submitting this authorization, you are certifying you have appropriate legal rights to access medical and health insurance information for the child indicated below. You can access your child's information through your own MyChart account. If you do not have your own MyChart account you can click here to sign up for one online, or we will create an activation code for you.

PLEASE NOTE: In accordance with our policies, proxy access converts to a limited version on the child's 12th birthday and proxy access terminates on the child's 18th birthday.

Birth to 12 Years of Age: Parents and legal guardians are provided with full access to their child's MyChart account. A week before your child's 12th birthday, you will receive an email alerting you that your access will be transitioned to a limited proxy access the day before your child's birthday.

12 to 17 Years of Age: Parents and legal guardians are provided with limited access to their child's MyChart account. A week before the child's 18th birthday, you will receive an email alerting you that access will be terminated the day before your child's birthday.

Children under the age of 12 are not permitted to have their own individual MyChart account. Minor patients ages 12 to 17 years can request individual, full access to their own MyChart Account with the approval of their care provider.

After submitting this form, we will review your information and send an email to the email address provided within 5 business days. We will contact you via the phone number provided if there are any questions regarding the information you have submitted.

Only a child who has been seen by a UChicago Medicine provider will have a MyChart account.

Need MyChart Help?

Call the University of Chicago Medicine at 1-844-442-4278.

Information about the Child & Parent/Legal Guardian (Proxy):

*Required Field

Child's First Name:
Child's Middle Name:
Child's Last Name:
Child's Legal Sex:
Child's Date of Birth:
Child's Primary Care Provider:
Child's Street Address:
Child's City:
Child's State:
Child's Zip Code:
Proxy's First Name:
Proxy's Middle Name:
Proxy's Last Name:
Proxy's Legal Sex:
Proxy's Date of Birth:
Proxy's Street Address:
Proxy's City:
Proxy's State:
Proxy's Zip Code:
Proxy's Phone (XXX-XXX-XXXX):
Proxy's Email Address:
Comments:

***Please Read and Certify***

By submitting this form I certify that I am the birth/adoptive parent or legal guardian of the child listed above and that all information I have provided is true and accurate. I also agree to the Terms and Conditions for use of MyChart provided by The University of Chicago Medical Center. I hereby request access to my child's online medical record. I understand that MyChart access is a privilege. The University of Chicago Medical Center may terminate MyChart access at any time, if I do not comply with the UCMC MyChart terms and conditions.

Click here to review the terms and conditions of use of The University of Chicago Medical Center MyChart.

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How to Access Your Child's Medical Records on MyChart (Proxy Access)

Need MyChart Help?

Information about the Child & Parent/Legal Guardian (Proxy):