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A Veterans Affairs Request for and Authorization to Release Medical Records or Health Information, or VA Form 10-5345, is a document that will allow the collection of treatment records for doctors or any health care provider, once their active duty is completed if they have ever been treated at any Veterans Facility
Use VA Form 21-0845 to authorize VA to share your personal information with a non-VA (third-party) individual or organization.
This form is used to release your protected health information as required by federal and state privacy laws.
Use VA Form 21-0845 to authorize VA to share your personal information with a non-VA (third-party) individual or organization.
An authorization gives the non-VA provider authority to provide health care to the Veteran patient, and provides assurance of payment for those services. The authorization document binds VA to the language that is included on the authorization.
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Youll need to bring a government-issued photo ID. You can use your Veteran Health Identification Card or a valid drivers license. A VA staff member will verify your identity. Theyll then record your information in the MyHealtheVet system, and confirm that youre eligible for a Premium account.
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.
Authorize VA to release your information to a third-party source (VA Form 21-0845)

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