VA Form 10-0527-CHOICE Request and Authorization to Release Protected Health Information to the Choice Program

VA Form 10-0527-CHOICE Request and Authorization to Release Protected Health Information to the Choice Program

What Is VA Form 10-0527-CHOICE?

This is a legal form that was released by the U.S. Department of Veterans Affairs on June 1, 2015 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is VA Form 10-0527-CHOICE?
A: VA Form 10-0527-CHOICE is a form used to request and authorize the release of protected health information to the Choice Program.

Q: What is the Choice Program?
A: The Choice Program is a program that allows veterans to receive healthcare services from selected non-VA providers.

Q: Why would I need to fill out VA Form 10-0527-CHOICE?
A: You would need to fill out this form if you want to authorize the release of your protected health information to the Choice Program.

Q: What is protected health information?
A: Protected health information refers to any information about your health or healthcare services that is protected by privacy laws.

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Form Details:

  • Released on June 1, 2015;
  • 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;

Download a fillable version of VA Form 10-0527-CHOICE by clicking the link below or browse more documents and templates provided by the U.S. Department of Veterans Affairs.

Download VA Form 10-0527-CHOICE Request and Authorization to Release Protected Health Information to the Choice Program

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  • VA Form 10-0527-CHOICE Request and Authorization to Release Protected Health Information to the Choice Program, Page 1
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