VA Form 10-10164 Opt-Out of Sharing Protected Health Information Through Health Information Exchanges

VA Form 10-10164 Opt-Out of Sharing Protected Health Information Through Health Information Exchanges

What Is VA Form 10-10164?

This is a legal form that was released by the U.S. Department of Veterans Affairs on April 1, 2020 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2020;
  • The latest available edition released by the U.S. Department of Veterans Affairs;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of VA Form 10-10164 by clicking the link below or browse more documents and templates provided by the U.S. Department of Veterans Affairs.

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Download VA Form 10-10164 Opt-Out of Sharing Protected Health Information Through Health Information Exchanges

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  • VA Form 10-10164 Opt-Out of Sharing Protected Health Information Through Health Information Exchanges, Page 1
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