Va form 10 5345-2025

1. Click ‘Get Form’ to open the VA Form 10-5345 in the editor.
2. Begin by entering your personal information, including your last name, first name, middle name, and date of birth. Ensure accuracy to avoid delays in processing.
3. Fill in your mailing address completely, including city, state, and zip code. This is crucial for any correspondence regarding your request.
4. Specify the organization or individual to whom the information should be released. Clearly state their name and address.
5. Indicate the purpose for requesting this information by checking the appropriate box (e.g., treatment, benefits). You may also specify other needs if applicable.
6. Select the type of information you are requesting by checking the relevant boxes. Be specific about dates and types of records needed.
7. If applicable, review and complete the section on sensitive diagnoses. Check boxes as necessary based on your preferences for disclosure.
8. Sign and date the authorization section at the bottom of the form. If a legal representative is signing, ensure they provide their relationship to you.

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