Vcuhealth newsvcu-health-system-andVCU Health System and Riverside Tappahannock Hospital 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in your full name in the designated field. This is essential for identifying the patient whose records are being requested.
3. Indicate whether you are authorizing the release or obtaining health information by checking the appropriate box.
4. Provide the recipient's name, address, and contact details where the information will be sent or obtained from. Ensure all fields are accurately filled to avoid delays.
5. Select which specific health records you wish to release or obtain by checking the relevant boxes, such as Discharge Summaries or Laboratory Reports.
6. Specify how you would like to receive your records—via email, mail on a CD, paper copies, or pickup—by checking the corresponding option.
7. Finally, sign and date the form at the bottom. If applicable, indicate your relationship if someone else is signing on behalf of the patient.

Start using our platform today for free to streamline your document editing and signing process!