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About VA Form 10-5345

Form name: Request for and Authorization to Release Health Information
Related to: Health care
Form last updated: October 2023

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

Download VA Form 10-5345 (PDF)
  • Securely view, download, and share your medical records.