Vidant medical records 2025

1. Click ‘Get Form’ to open the vidant medical records in the editor.
2. In Section A, enter the patient's name and any prior names. Fill in the street address, last four digits of the Social Security Number, city, date of birth, state, zip code, and telephone number.
3. Proceed to Section B to specify who will provide the information. In Section C, indicate who will receive it by filling in the Vidant Health Entity's name, address, and phone number.
4. In Section D, choose how you would like to receive the information: via mail, pick up, or email. If selecting email, provide your email address.
5. Section E requires you to describe the reason for your request. Select from options such as attorney/legal or personal use.
6. In Section F, detail the specific Protected Health Information needed and include relevant dates.
7. Review Sections G and H for understanding and expiration details before signing in Section I. Ensure all required signatures are completed.

Start using our platform today for free to streamline your vidant medical records process!