Get your records in person
We can help you get copies of your VA medical records. Call or visit the Release of Information office at the Spark M. Matsunaga campus.
What to bring
- A completed and signed Individuals’ Request For a Copy of Their Own Health Information (VA Form 10-5345a). If records are being provided back to the patient. Download VA Form 10-5345a (PDF)
- Or a completed and signed Request For and Authorization to Release Health Information (VA Form 10-5345) if records are being provided to anyone other than the patient. Download VA Form 10-5345
- Your Veteran Health Identification Card (VHIC)
Release of Information office locations
Release of Information Office
Second floor
Map of Spark M. Matsunaga campus
Phone: 808-433-7713 Fax 808-433-0205 Email V21HonROI@va.gov
Hours: Monday through Friday, 7:00 a.m. to 3:30 p.m. HT
Get your records by mail or fax
To request a copy of your VA medical records by mail, fax, or secure Message. Send a signed and completed VA Form 10-5345a to our Release of Information office.
If records are being provided back to the patient, Download VA Form 10-5345a (PDF)
If records are being provided to anyone other than the patient, Download VA Form 10-5345
VA Pacific Islands Medical Center
Release of Information
459 Patterson Road
Honolulu, HI 96819
Fax your signed form to
808-433-0205
Secure Message using your Premium MyHealtheVet account
Send to *Release of Information (ROI) – VA Pacific Islands
We process all requests within 20 days. For privacy reasons, we are unable to send medical records by email and electronic signatures are not accepted at this time.
How we share your records with providers outside VA
The Veterans Health Information Exchange (VHIE) program lets us electronically share your health information with health care providers who treat you, including participating non-VA providers if you receive care outside of VA.
This program is voluntary, and you can choose not to share your information (opt out of sharing).
Learn more about VHIE
To opt out of sharing
Fill out, sign, and date VA Form 10-10164 (Opt Out of Sharing Protected Health Information).
Mail the signed, completed form to our ROI office. You can also bring it with you or ask for this form when you visit us.
Download VA Form 10-10164 (PDF)
Note: If you had revoked your permission to share, before September 30, 2019, your opt out status will stay active. You don’t need to submit form 10-10164.
To allow sharing after opting out
If you change your mind and want to share your health information, you’ll need to submit VA Form 10-10163 (Request for and Permission to Participate in Sharing Protected Health Information).
Mail the signed, completed form to our Release Of Information office. You can also bring it with you or ask for this form when you visit us.
Download VA Form 10-10163 (PDF)