Mychart everett clinic 2026

1. Click ‘Get Form’ to open the Child Proxy Form in the editor.
2. Begin by entering the Patient Name and Date of Birth at the top of the form. This information is crucial for identifying your child’s MyChart account.
3. Fill in the Medical Record Number (MRN) if available, as this will help streamline access to your child's medical records.
4. Complete the Parent/Guardian Information section. Ensure all fields are filled out clearly, including your name, date of birth, address, email, and phone number.
5. Provide details for each child requiring proxy access. Remember that a separate form is needed for each child.
6. Review the MyChart Terms and Agreement carefully. Acknowledge your understanding by signing and dating at the bottom of the form.
7. Submit the completed form to The Everett Clinic via mail or fax as indicated on the document.

Start using our platform today to easily fill out and submit your Child Proxy Form for free!