About VA Form 21-4142
- Related to: Disability, Health care
- Form last updated: May 2023
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 PDFDownload VA Form 21-4142 (PDF)
You can submit your authorization online instead of sending us the paper form.Go to the online tool
Helpful links related to VA Form 21-4142
Securely view, download, and share your medical records.
Learn about the steps for filing a claim for disability compensation or increased disability compensation.
Learn about filing a Supplemental Claim and adding new evidence to support your case.