
ARKANSAS DEPARTMENT OF HEALTH VITAL RECORDS ERAVE USER APPLICATION FORMAdministrative Use Only Account Created on (Date): Initials Roles Assigned on (Date):InitialsDirections: Complete form and sign.
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How to fill out the Erave online
The Erave user application form is essential for accessing vital records in Arkansas. This guide provides detailed instructions on how to complete the form accurately and efficiently.
Follow the steps to complete the Erave user application form online.
- Click ‘Get Form’ button to obtain the Erave user application form and open it in the designated editor.
- Begin by filling out the applicant's data. Required fields include the first name, last name, business address, primary phone number, and preferred contact method. Ensure that mandatory information is filled accurately.
- Provide any additional contact information such as the middle name/initial, email address, fax number, and mobile phone details for receiving text alerts.
- Specify the ERAVE roles by listing each group and location combination separately. Choose from the permission groups available, including funeral director, physician, medical examiner, and others.
- If applicable, enter your license number and type. This is required for users such as physicians, funeral directors, and hospice registered nurses.
- Review the user agreement section. By signing this form, you acknowledge the purpose of the Erave system and agree to use it responsibly.
- Sign and date the application at the bottom of the form to confirm your understanding and acceptance of the agreement.
- Once completed, you can save your changes and choose to either download, print, or share the form as needed. Additionally, fax the completed form to 501-683-6646 or mail it to the provided address.
Start filling out the Erave user application form online today to access vital records.
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