VA Form 10-5345, Request for and Authorization to Release Health Information is a document issued by the Department of Veterans Affairs (VA). It is used to get a veteran's written and signed authorization to release their medical data according to the Health Insurance Portability and Accountability Act. The VA may also apply the details provided in this paper to identify the individuals claiming or receiving any VA benefits.
The latest version of the form was released by the VA in September 2018. An up-to-date fillable version of the form is available for download below or can be found on the VA website.
You are required to submit your request to VA if you need to disclose your medical data to any individual or organization for treatment, employment, legal or other purposes. You must fill out this document when submitting an application for VA benefits.
VA Form 10-5345 has two related forms: