Skip to Content
Your browser is out of date. To use this website, please update your browser or use a different device.
U.S. flag

An official website of the United States government

About VA Form 10-10163

Form name: Request for and Permission to Participate in Sharing Protected Health Information through Health Information Exchanges
Related to: Health care
Form last updated: September 26, 2019
Download VA Form 10-10163 (PDF)
Last updated: