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Link to form
https://www.va.gov/vaforms/medical/pdf/VHA Form 10-5345a Fill-revision.pdf
Form number
10-5345a
Row ID
4427
Form title
Individuals' Request for a Copy of Their Own Health Information - fill
Issue date
Revision date
Form administration
VHA
Number of pages
1
Deleted
False
Form name
Individuals' Request for a Copy of Their Own Health Information
Form Language
English
Related to
Benefits
VA health care
VA records