MyChildren's - Request Activation Code

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For parents and guardians without an activation code.

Your Information

Your first name:

Your last name:

Your date of birth:

Your legal sex:

Your mobile phone:

Your other phone:

Street address:

City:

Select Other if your state or province is not listed.

State/Province:

ZIP:

Country:

Email:

Your Child's Information

Your child's first name:

Your child's last name:

Your child's date of birth:

Your child's legal sex:

Medical Record Number (MRN):

Street address:

City:

Select Other if your state or province is not listed.

State/Province:

ZIP:

Country:

Patient's relationship to you:

If other, please specify:

Right to access:

I certify that I have the legal right to this patient's medical information.

To add more children to your account go to Account Settings > Add a Patient in the MyChildren's menu, or call us at 617-919-4396.

Need Help? Call Digital Health Support at 617-919-4396. We are available Monday, Tuesday, Wednesday, and Friday from 7 a.m. to 5:30 p.m.; Thursday from 7 a.m. to 6:30 p.m.; and Saturday from 8 a.m. to 1 p.m.