MyChart - Sign Up

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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First name

Middle name

Last name

Date of birth

Legal sex

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Home phone

Work phone

Mobile phone

Last four digits of SSN

Email address

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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.

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

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Name

Address

Other information

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Patient information

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Address

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