MyChart - Sign Up

We need some information to grant you a MyChart account. After you submit this request, it may take up to a week for processing and verification. When you're approved, you will receive an email or a letter with your activation code and instructions on how to activate your MyChart account. If you have any questions, please contact us at 1-833-395-2035.

Follow these steps to sign up for a MyChart account.

Enter your personal information.

Verify your contact information.

Choose a username and password.

If you have any questions, please contact us at 1-833-395-2035.

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Follow these steps to sign up for a MyChart account.

Enter your personal information.
Verify your identity.
Choose a username and password.

If you have any questions, please contact us at 1-833-395-2035.

Get a MyChart account now to access your health information. Fill out your information below and answer a few questions to verify your identity. Let’s get started!

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Please complete the form below. If you have any questions, please call 1-833-411-KINW (5469) for assistance.

We need to collect some information about the patient in order to schedule this appointment. If you have any questions, please contact your clinic.

First name

Middle name

Last name

Date of birth

Legal sex

Female Male Unknown Other

Home phone

Work phone

Mobile phone

Last four digits of SSN

Email address

Verify email address

I understand that by clicking on the SUBMIT button immediately following this notice, I am providing ‘written instructions’ to Providence Health & Services (Providence) under the Fair Credit Reporting Act authorizing Providence to obtain information from my personal credit profile or other information from Experian (identity verification software). I authorize Providence to obtain such information solely to confirm my identity prior to activation of a MyChart account in my name. I understand that by clicking on the SUBMIT button immediately following this notice, I am providing ‘written instructions’ to Kinwell under the Fair Credit Reporting Act authorizing Kinwell to obtain information from my personal credit profile or other information from Experian (identity verification software). I authorize Kinwell to obtain such information solely to confirm my identity prior to activation of a MyChart account in my name.

In order to grant you a MyChart account, we will verify your identity using questions from a third-party verification system. Once verified, you will be able to create your MyChart account. If you have any questions, please contact your clinic.

We are checking with a third-party system to verify your identity. This may take several seconds.

In order to grant you a MyChart account, we will verify your identity using questions from a third-party verification system. Once verified, you will be able to create your MyChart account. If you have any questions, please contact your clinic.

These questions are generated by a third-party system to verify your identity.

Sign Up

Name

Address

Other Information

Sign Up

Patient Information

Name

Address

Other Information

Unable to Verify Your Identity

Unable to Verify Your Identity