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The document is a General Release for Medical Provider Information to the Department of Veterans Affairs (VA), requiring veterans to provide their personal and medical provider information to authorize the VA to obtain their treatment records. It includes sections for patient identification, medical provider details, and emphasizes the importance of accurate information under the Privacy Act.

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Versions	Form popularity	Fillable & printable
2018	4.9 Satisfied (35 Votes)
2014	3.9 Satisfied (56 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Is it difficult to get VA unemployability?

Applying for VA unemployability benefits can be a complex and arduous process, with many veterans facing denials for their claims.

How do I download VA forms?

How to download and open a VA.gov PDF form Click the Download VA form link for the form you want to fill out. The PDF will download to your Downloads folder. Open Adobe Acrobat Reader. From the File menu, choose Open. Go to your Downloads folder or the location on your device where you saved the PDF.

How much does VA pay for ile dysfunction?

Use VA Form 21-4142 to give us permission to obtain your personal information from a non-VA source like a private doctor or hospital. Examples of personal information may include your medical treatment, hospitalizations, psychotherapy, or outpatient care.

What is VA form 21 0172?

If the Department of Veterans Affairs (VA) certifies that you have a permanent and total disability, you can substitute VA Form 21-0172, Certification of Permanent and Total Disability, for the physicians statement you are required to keep. VA Form 21-0172 must be signed by a person authorized by the VA to do so.

How to obtain VA form 21 0172?

VA Form 21-0172 must be signed by a person authorized by the VA to do so. You can get this form from your local VA regional office.

va form 21 4142a printable

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Is VA correcting an error a good thing?

Keep in mind that while identifying an error can sound concerning, its an error made by the VA, not the veteran, so having the VA identify and fix their mistake is typically a positive development.

Who signs VA form 21 10210?

VA Form 21-10210 must be signed and dated by the Veteran, the claimant, or the witness. Signatures must be made in ink.

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Is it difficult to get VA unemployability?

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What is VA form 21 0172?

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Is VA correcting an error a good thing?

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