RESTRICTION OF THE RELEASE OF INDIVIDUALLY-IDENTIFIABLE HEALTH INFORMATION THROUGH eHEALTH EXCHANGE
If you are unable to find your form here, you may want to visit:
Please send your comments or questions to
Veterans Crisis Line:
1-800-273-8255 (Press 1)
U.S. Department of Veterans Affairs | 810 Vermont Avenue, NW Washington DC 20420
Last updated January 20, 2017.