About VA Form 10-5345
- Form name: Request for and Authorization to Release Health Information
- Related to: Health care
- Form revision date: July 2021
When to use this form
Use VA Form 10-5345 to authorize us to share your health information with a non-VA (or third-party) individual or organization.
Downloadable PDF
Helpful links related to VA Form 10-5345
-
Securely view, download, and share your medical records.