Housing Application

Application to Stay at the Seattle Ronald McDonald House

Fields marked with an * are required

Please note that you will also have to submit a background check form in addition to this application.

Only fill this form out if you are eligible to stay with RMHC, meaning you 1) are coming for 45 or more miles away from Seattle, WA 2) have a child receiving treatment for a serious illness at Seattle Children's Hospital and 3) are planning to stay at RMHC in the next two weeks. Due to our workload, we can only accept applications two weeks in advance. Thank you!

Patient Information


Please note that if you have international phone numbers with a prefix, this form does not accommodate them. Please type (000) 000-000 into the box above and any other phone boxes if you have a phone outside of the US. We will follow up with you via email for your phone number.

Visit Information

HIPAA Release

In order to access Seattle Children’s Hospital records to confirm demographic information and appointment/admission schedules, please review and sign the following: I authorize RMHC and Seattle Children’s Hospital staff to share pertinent information regarding my child’s care and/or treatment. I also authorize RMHC to release pertinent medical/non-medical information, including appointment schedules, regarding my child’s care and/or treatment to Medicaid/Medicare or its agents to determine benefits for housing needs.

If the patient is 18 years of age or older, the HIPAA release must be signed by him/her.

Parent or Guardian Information

Contribution Information

While we encourage families to contribute $30 per night when they stay with us, we understand many are struggling financially. Thanks to donations from our community, no one is ever turned away due to inability to contribute. We accept medical insurance and Medicaid.

Room Guest Information

Our rooms can accommodate a maximum of six people. We will need the first name, last name, birth date, relationship to patient, phone and email for anyone who will be staying in the room. Please enter information as necessary below for each room guest. It is not necessary to repeat information you have already entered into the form, like patient names or the above parent/legal guardian. If you have no other room guests, please scroll to the bottom of the form to submit.

Our Mission:

At Ronald McDonald House Charities® of Western Washington & Alaska, we support seriously ill children and their families. At the Seattle House, we provide a "home-away-from-home" to help families through a difficult time. We also provide a van service for families staying in Anchorage while their children receive medical care.

Follow Us

Get social with us to learn more about our families and happenings at the House.

Contact Us

5130 40th Ave NE

Seattle, WA 98105

Phone: 206.838.0600

Icons made by Freepik from www.flaticon.com are licensed under CC BY 3.0 | View our Privacy Policy