About VA Form 21-4142
- Form name: Authorization to Disclose Information to the Department of Veterans Affairs (VA)
- Form revision date: August 2024
- Related to: Disability, Health care
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
Online tool
You can submit your authorization online instead of sending us the paper form.
Helpful links related to VA Form 21-4142
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Securely view, download, and share your medical records.
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Learn about the steps for filing a claim for disability compensation or increased disability compensation.
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Learn about filing a Supplemental Claim and adding new evidence to support your case.