Fill and Sign VA 10-5345 Forms

What Is VA Form 10-5345 Series?

The VA 10-5345 Forms are released by U.S. Department of Veterans Affairs (VA) and filled out by veterans in order to gain electronic access to their medical records, to obtain a copy of them in paper form, or to provide specific health information to a third party.

Alternate Name:

  • VA Medical Records Release Forms.

Fillable versions of the VA 10-5345 Forms are available for download below. This series includes three forms:

  1. VA Form 10-5345, Request For an Authorization To Release Medical Records or Health Information.
  2. VA Form 10-5345A, Individuals' Request for a Copy of Their Own Health Information.
  3. VA Form 10-5345A-MHV, Individuals' Request for a Copy of Their Own Health Information.

Any of these documents should be printed before or after completion and hand signed. The record release requests and authorizations must be submitted in person or via mail. Emailed forms are not accepted. If either of the forms is signed by the legal representative of a veteran, the supporting papers indicating the corresponding authority must be attached. VA Form 10-5345A-MHV is usually processed within 12 hours if submitted in person. It may take 10 to 30 days to process VA Form 10-5345 and VA Form 10-5345A.

All health data maintained by the VA should be private and protected according to the Health Insurance Portability and Accountability Act (HIPAA), 45 CFR Parts 160, and 164. HIPAA is the act that sets standards for the security of electronic medical records and individually identifiable health information. The VA is obliged to ensure that any information about physical, mental health, provision of health care, payments for health care, and other details concerning veteran’s treatment should not be transferred to a third party without the written consent of the veteran.

The veterans have the right to obtain and inspect the copy of their own confidential health care data, as well as to allow the third party to access this information. The veteran may need the medical records for employment, to request certain benefits, or for further treatment. In order to disclose the health information, the VA has to obtain authorization from the veteran. This authorization must be in a written form and contain the data necessary for proper identification of the service member (full name, SSN, date of birth).

The VA 10-5345 Forms were created for the veterans to request their medical data or to provide authorization to release information to a certain person or organization in a simple and convenient manner. Besides, the series gives an individual the possibility to limit the release of sensitive diagnoses, such as drug abuse, alcohol abuse, human immunodeficiency virus, or sickle cell anemia.

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Documents:

3

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  • Name
  • Form number
  • Size

This form is mainly used by veterans to request a copy of their health records maintained by the Department of Veterans Affairs (VA).

This document is used to get the veterans' written and signed authorization to release their medical data according to the Health Insurance Portability and Accountability Act.

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