Vanderbilt hospital medical records: Fill out & sign online

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Click ‘Get Form’ to open the Vanderbilt Hospital Records 2012 form in the editor.
Begin by filling out your personal information in the 'Patient Identification' section, including your name, date of birth, address, and phone number.
In the 'Release Records To' section, specify where you want the medical records sent. You can choose to have them sent to yourself or another individual or agency.
Indicate the specific medical records you wish to request by checking the appropriate boxes under 'Information Requested.' Be sure to clarify if you need psychotherapy notes as a separate authorization is required for those.
Complete any additional fields regarding dates of treatment and purpose of release. This helps ensure that only relevant information is shared.
Finally, review all entered information for accuracy before signing and dating the form at the bottom. Ensure that you understand your rights regarding this authorization.

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