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Start time: Friday, September 11, 2026, at 8:00 p.m. ET
End time: Friday, September 11, 2026, at 8:30 p.m. ET

VA Form 10-5345

Form name:Request for and Authorization to Release Health Information
Form revision date: May 2026
Related to: Health care

When to use this form

Use VA Form 10-5345 to authorize us to share your health information with a non-VA (or third-party) individual or organization.

Downloadable PDF