Vanguard Health Systems (VHS) S-4 Registration of securities issued in business combination transactions

Exhibit 3.131

State of Delaware

Secretary of State

Division of Corporations

Delivered 02:21PM 02/06/2012

FILED 02:19PM 02/06/2012

SRV 120126655 - 5105578 FILE

STATE of DELAWARE

LIMITED LIABILITY COMPANY

CERTIFICATE of FORMATION

Ÿ	First: The name of the limited liability company is__________________________________
	Vanguard Medical Specialists, LLC
Ÿ	Second: The address of its registered office in the State of Delaware is________________
	160 Greentree Drive, Suite 101 in the City of Dover, DE 19904 County of Kent._________
	The name of its Registered agent at such address is National Registered Agents, Inc. ____
	________________________________________________________________________________
Ÿ	Third: (Use this paragraph only if the company is to have a specific effective date of
	dissolution.) "The latest date on which the limited liability company is to dissolve is
	______________________."
Ÿ	Fourth: (Insert any other matters the members determine to include herein.)
	________________________________________________________________________________
	________________________________________________________________________________
	________________________________________________________________________________
	________________________________________________________________________________
	________________________________________________________________________________
	________________________________________________________________________________
	________________________________________________________________________________
In Witness Whereof, the undersigned have executed this Certificate of Formation of
Vanguard Medical Specialists, LLC_____  this 6th _____  day of February , 2012 .
	BY:	/s/ Deborah T. McCormick
		Authorized Person(s)
	NAME:	Deborah T. McCormick, Vice President
		Type or Print