Service Coordination and Lab Order Information Authorization
Permission for Vitals Vault to send the information needed to coordinate a health service you request.
Effective September 2, 2026
This authorization lets Vitals Vault send the information needed to coordinate the health services I request with independent professionals, labs, collection providers, pharmacies, and other service partners.
Information covered
Identity and contact details, date of birth, location, health history, medications, allergies, symptoms, intake responses, order details, payment or eligibility status, and other information reasonably needed for the service I request.
Who may receive it
Independent licensed professionals and medical groups, laboratories, specimen-collection providers, pharmacies, fulfillment providers, and vendors helping Vitals Vault provide the requested service.
Purpose
To confirm eligibility, obtain clinical review, create and fulfill an order, schedule collection, provide account support, communicate about the service, and meet legal or safety duties.
Clinical decisions
A licensed professional, not Vitals Vault, decides whether a test, prescription, treatment, or other clinical service is appropriate.
Your choice
Signing is voluntary, but Vitals Vault may be unable to coordinate a service you request without the information needed to provide it. This authorization does not permit marketing use.
If I sign for a minor or another person for whom I have legal authority, “I,” “me,” and “my” refer to that person where appropriate. I confirm that I have authority to sign for that person.
By accepting the Vitals Vault consent bundle, I confirm that I have read this authorization and sign it electronically.