Patient Identity
Name, date of birth, and mailing address of the Veteran whose records will be released.
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VA Health Records Release
Give the VA permission to share your health records with a doctor, lawyer, employer, or anyone else you choose.
VA Form 10-5345 is the official HIPAA authorization that lets the Department of Veterans Affairs release your medical records to another person or organization. You control which records are released, who receives them, and when the authorization expires.
Average time
10-15 minutes
Difficulty
moderate
Best for
Veterans who need to share their VA health records with a health care provider, attorney, insurance company, employer, or for personal use
Help Veterans quickly and correctly authorize release of exactly the health records they need, without oversharing sensitive diagnoses or leaving the form legally incomplete.
Do not sign a blank or partially completed form. Be specific about which records and date ranges you need — VA can only release what you explicitly authorize.
Name, date of birth, and mailing address of the Veteran whose records will be released.
Name and address of the person or organization VA will send your records to.
The purpose or purposes for the release — required by HIPAA and determines whether page 2 applies.
Check every category of record you need — VA will only release what you specifically authorize.
For non-treatment releases only: your separate authorization to share drug abuse, alcohol, HIV, or sickle cell anemia records.
One of three required expiration options: after one use, on a specific date, or when a condition is met.
Ink signature (patient or legal representative) and the date signed — makes the release legally valid.
Docgle asks calm, plain-English questions and keeps the official source attached for review.
Start va-health-information-release-10-5345 walkthrough