Veterans Administration Medical Records Release Form

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About VA Form 10-5345 | Veterans Affairs

https://www.va.gov/find-forms/about-form-10-5345/

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: Health …

About VA Form 21-4142 | Veterans Affairs

https://www.va.gov/find-forms/about-form-21-4142/

Form name: Authorization to Disclose Information to the Department of Veterans Affairs (VA) Related to: Disability, Health care Form last updated: June 2022 …

VA Records | Veterans Affairs

https://www.va.gov/records/

Request your military records (DD214) View and print documents from your official military personnel file (including your DD214). Get your VA medical records (called VA Blue Button) Set …

VA Form 3288, REQUEST FOR AND CONSENT …

https://www.va.gov/vaforms/va/pdf/VA3288.pdf

I hereby request and authorize the Department of Veterans Affairs to release the following information from the records identified above to the organization, agency, or individual …

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 Request for and …

Medical Records Office | VA San Francisco Health Care

https://www.va.gov/san-francisco-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 …

VA Form 10-5345, Request for Consent to Release …

https://www.warrelatedillness.va.gov/WARRELATEDILLNESS/docs/HealthCare_Provider_ROI_FORM.pdf

information requested on this form is solicited under Title38, U.S.C. and will authorize release of information you specify. Your disclosure of the information requested on this …

HIPAA Compliance - Private Provider Information

https://www.benefits.va.gov/privateproviders/compliance.asp

SECTION I - RECORDS TO BE RELEASED TO THE DEPARTMENT OF VETERANS AFFAIRS (VA) I voluntarily authorize and request disclosure (including paper, oral, and …

VA New Mexico Health Care | Veterans Affairs

https://www.va.gov/new-mexico-health-care/

VA New Mexico health care. At VA New Mexico Healthcare System, our health care teams are deeply experienced and guided by the needs of Veterans, their families, and …

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