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Link to form
https://www.va.gov/vaforms/medical/pdf/10-259 Revocation of Authorization for R…
Form number
10-259
Row ID
10627
Form title
Revocation of Authorization for Release of Release of Individually-Idenrifiable Health Information
Issue date
Revision date
Form administration
VHA
Number of pages
1
Deleted
False
Form name
Revocation of Authorization for Release of Release of Individually-Identifiable Health Information
Form Language
English
Related to
Benefits
VA health care
VA records