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How to fill out the Cigna Sp1813 Form online
Filling out the Cigna Sp1813 Form online is essential for authorizing the release of your medical records. This guide will provide clear, step-by-step instructions to help you complete the form accurately and efficiently.
Follow the steps to fill out the Cigna Sp1813 Form online
- Click ‘Get Form’ button to access the Cigna Sp1813 Form and open it for editing.
- Begin filling out Part 1 by entering the patient’s information, including their full name, date of birth, daytime phone number, identification number, home phone number, and address.
- Move to Part 2, where you will specify the destination of the medical records. Provide the recipient's name, phone number, and address.
- In Part 3, state the purpose of the records release. It could be for continuation of care, personal use, or other specified reasons. If for future appointments, include the date of appointment.
- Proceed to Part 4 to indicate the type of records you are requesting. This may include co-pay statements, copies of past treatment records, or laboratory results. Ensure to provide specific dates if required.
- If you require diagnostic images, complete Part 5 by specifying your request for x-ray films or reports, including necessary exam dates.
- Sign the form at the end, ensuring that the patient, or their authorized representative, completes the signature section along with the date.
- After filling out all sections, review the document for accuracy. You can then save changes, download, print, or share the completed form as needed.
Complete your Cigna Sp1813 Form online today to ensure your medical records are released without delay.
To get reimbursed for HSA expenses, collect all necessary documentation, such as bills and receipts. You can then submit a claim through your HSA administrator or, for Cigna members, use the Cigna Sp1813 Form to ensure all details are correctly included for quick processing.
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