Skip to Content
Your browser is out of date. To use this website, please update your browser or use a different device.
U.S. flag

An official website of the United States government

About VA Form 21-4142a

Form name: General Release for Medical Provider Information to the Department of Veterans Affairs (VA) (Fillable)
Related to: Disability, Health care
Form last updated: August 24, 2020
Download VA Form 21-4142a (PDF)
Last updated: