About VA Form 21-4142
- Form name: Authorization to Disclose Information to the Department of Veterans Affairs (VA)
- Related to: Disability, Health care
- Form last updated: June 2022
When to use this form
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.
Downloadable PDF
Download VA Form 21-4142 (PDF)Helpful links related to VA Form 21-4142
-
Get your VA medical records online
Securely view, download, and share your medical records.
-
How to file a VA disability claim
Learn about the steps for filing a claim for disability compensation or increased disability compensation.
-
File a Supplemental Claim
Learn about filing a Supplemental Claim and adding new evidence to support your case.