MyUCDavisHealth -

If you are a UC Davis Health patient:
Please enter your contact information below to receive access to your own medical record. An enrollment letter containing your MyUCDavisHealth Activation Code and instructions on how to proceed will arrive via e-mail. Please allow two business days to receive your Activation Code.

Do not use this form to request access to a family member's chart. Please click the following link for additional information on how to request access to a chart which is not your own. How To Obtain Access To A Family Member's Chart

Improperly obtaining access to another's medical records without a valid patient authorization is against State and Federal confidentiality law and is subject to fines and/or imprisonment.

Medical Record Number

Help with Medical Record Number

First Name

Middle Name

Last Name

Address

City

State

Zip

DOB

Complete Date of Birth is Required, submissions without DOB will not be processed

Home Phone Number

Alternate Phone Number

E-mail Address

Primary Care Provider

I am at least 12 years old and am requesting access to my own chart.

I accept the Terms and Conditions.

Terms and Conditions

By checking this box I am confirming my identity as the patient stated above.

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Sign Up For Access To Your Own Medical Records