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About VA Form 10-5345 | Veterans Affairs

    https://www.va.gov/find-forms/about-form-10-5345/
    Home Find a VA form About VA Form 10-5345 About VA Form 10-5345 Form name: Request for and Authorization to Release Health Information Related to: …

REQUEST FOR AND AUTHORIZATION TO …

    https://www.va.gov/vaforms/medical/pdf/VA_Form_10-5345_%20Fillable.pdf
    The information requested on this form is solicited under Title 38 U.S.C. The form authorizes release of information in accordance with the Health Insurance Portability …

About VA Form 21-4142 | Veterans Affairs

    https://www.va.gov/find-forms/about-form-21-4142/
    About VA Form 21-4142 Form name: Authorization to Disclose Information to the Department of Veterans Affairs (VA) Related to: Disability, Health care Form last …

REQUEST FOR AND AUTHORIZATION TO …

    https://www.va.gov/files/2021-11/roi.pdf
    information requested on this form is solicited under Title 38 U.S.C. The form authorizes release of information in accordance with the Health Insurance Portability and …

INDIVIDUALS' REQUEST FOR A COPY OF THEIR …

    https://www.va.gov/vaforms/medical/pdf/VHA%20Form%2010-5345a%20Fill-revision.pdf
    The purpose of this form is to provide an individual the means to make a written request for a copy of their information maintained by the Department of Veteran Affairs (VA) in …

Find A VA Form | Veterans Affairs

    https://www.va.gov/find-forms/
    Find out how to change your address and other contact information in your VA.gov profile for disability compensation, claims and appeals, VA health care, and other …

VA Form 3288, REQUEST FOR AND CONSENT …

    https://www.va.gov/vaforms/va/pdf/VA3288.pdf
    NAME AND ADDRESS OF ORGANIZATION OR INDIVIDUAL TO WHOM INFORMATION IS TO BE RELEASED. VETERAN'S REQUEST. I hereby request and authorize the …

Medical Records / Release of Information - Veterans Affairs

    https://www.va.gov/central-ohio-health-care/medical-records-office/
    To request a copy of your VA medical records by mail or fax, send a signed and completed VA Form 10-5345a to our Release of Information office. Download VA …

Veterans Affairs Request for and …

    https://eforms.com/release/va/
    Veterans Affairs Request for and Authorization to Release Medical Records or Health Information (VA Form 10-5345) Updated June 03, 2022. A Veterans Affairs …

AUTHORIZATION TO DISCLOSE INFORMATION …

    https://www.vba.va.gov/pubs/forms/VBA-21-4142-ARE.pdf
    RESPONDENT BURDEN: We need this information and your written authorization to obtain your treatment records to help us get the information required to process your …



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