Partial HSA transfer from HSA to Fidelity HSA -- what to enter in form?

https://preview.redd.it/paqkgiy85b3e1.png?width=1558&format=png&auto=webp&s=1fbc20cb3daa8ecb8f00aa15ff14d25d43ecfb86

My workplace HSA allows partial transfers of HSA funds to be sent by check. Can Fidelity handle this? If yes, what do I enter in institution, account number, .. ? Thanks!