Forms DB Data
The following information about this VA form comes from the VA forms database, and any changes are updated here nightly. Contact the form administration for further information.
Form number
10-5345
Row ID
10573
Form title
Request for and Authorization to Release Health Information
Issue date
Revision date
Form administration
Number of pages
2
Deleted
False
Form name
Request for and Authorization to Release Health Information
Form Language
English
When to use
Use VA Form 10-5345 to authorize us to share your health information with a non-VA (or third-party) individual or organization.