VA 10-5345 Forms and Templates

2
total templates

What Is VA Form 10-5345 Series?

The VA 10-5345 forms series is a set of three forms issued by the Department of Veterans Affairs (VA). These documents must be filled out and signed 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.

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.

All three of the VA 10-5345 fillable forms can be found and downloaded down below. They are easy to complete since most of their fields are self-explanatory. However, if a veteran has any difficulty or questions, they may contact the Release of Information (RIO) staff for help. RIO offices are located at all VA Health Care Facilities. The address of the closest facility may be found on the VA website.

VA Medical Records Release Forms

The VA medical records release forms include:

  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; and
  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. E-mailed papers are not accepted. If the documents of the VA 10-5345 series are signed by the legal representative of a veteran, the supporting papers indicating the corresponding authority must be attached. The VA 10-5345A-MHV is usually processed within 12 hours if submitted in person. It may take 10 to 30 days to process the VA 10-5345 and VA 10-5345A.

 

Documents

2

VA Form 10-5345 Request for and Authorization to Release Health Information

Rate
4.6(4.6 / 5) 55 votes
Size: 1 MB
2 pages

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.

+ show tags - hide tags
VA Forms

VA Form 10-5345a-mhv Individuals' Request for a Copy of Their Own Health Information

Rate
4.4(4.4 / 5) 32 votes
Size: 1 MB
2 pages

The form is used by the veterans to request a copy of their medical data through My HealtheVet account.

+ show tags - hide tags
VA Forms Legal