Veterans sometimes need to share their medical records. For this, they use VA Form 10-5345. This form helps release health information. You might need it for insurance, new doctors, or personal use. Filling out forms can feel confusing. But don’t worry. This guide will help you step by step.
What Is VA Form 10-5345?
VA 10-5345 is a request form. It allows the Department of Veterans Affairs to release your health information. You use it when you want your medical records sent somewhere. That place could be a hospital, a family member, or a lawyer. This form protects your privacy. It ensures records go only to approved people or places.
When Should You Use VA Form 10-5345?
You should use this form when:
- You want to send your VA medical records to a new doctor
- You need records for an insurance claim
- You’re changing doctors or hospitals
- You want a personal copy of your records
- You are applying for non-VA health services
Using the form ensures the process is legal and safe.
Where to Get the Form
You can download VA 10-5345 from the official VA website.
Here’s the direct link:
https://www.va.gov/find-forms/about-form-10-5345
You can also get a copy at your local VA medical center. Most clinics have the form at the front desk.
How to Fill Out VA Form 10-5345 (Step-by-Step)
Now, let’s fill the form step by step. Take your time. Make sure all your information is correct.
Section 1: Patient Information
This is about you, the veteran.
- Write your full legal name
- Add your date of birth
- Include your Social Security number
- Enter your address, phone number, and email
- Double-check for spelling errors
Section 2: Person or Organization Receiving the Information
Who should receive your records?
- Write the full name of the person or company
- Include the full mailing address
- If available, add their phone or fax number
- Be clear and accurate here
Section 3: Description of Information to Be Released
Choose what medical records you want to release.
- You can check boxes like treatment history or mental health
- You may write specific dates or conditions
- Be sure to write clearly
Section 4: Purpose of the Request
Why are you sharing the records?
- You can write “For personal use,” “For medical treatment,” or “For insurance claim”
- You must fill in this section. Leave nothing blank.
Section 5: Expiration Date
Here, you set when this permission ends.
- Write a date (example: “12/31/2025”)
- Or, describe an event (example: “Until treatment ends”)
- After this date, no more records will be released
Section 6: Your Signature and Date
This is the most important part.
- Sign your name clearly
- Add the current date
- Unsigned forms will be rejected
Section 7: If Someone Else Signs for You
Sometimes someone else signs the form for you.
- They must include their name and relationship
- They may also need to show legal proof
- The VA might contact them for verification
Optional: Section for Notes
If needed, you can add more info on the back. This could include:
- Special instructions
- Contact information
- Extra details about your request
Submitting the Form
After filling out the form, you need to submit it. Here’s how:
- Mail it to your local VA health center
- Hand it in at the VA clinic front desk
- Or fax it to your VA medical records office
Always keep a copy for yourself.
How Long Does It Take?
Processing may take 10–14 business days. Times vary by location. If you need records urgently, call your VA center. They may speed up your request.
Tips for Avoiding Mistakes
Here are simple tips to avoid delays:
- Write clearly in black or blue ink
- Don’t leave required fields blank
- Double-check spelling and numbers
- Always sign and date the form
- Include the correct address for delivery
Conclusion
VA 10-5345 helps veterans control who sees their medical records. It is simple but must be filled out carefully. You can use this form for personal, legal, or medical reasons. Just follow the steps in this guide. Always keep a copy and track your request. If you need help, contact your VA center directly. This guide should help make the process easier. You now know how to fill VA 10-5345 correctly.
FAQs
1. What is the VA 10-5345 form used for?
It allows the VA to release your health records to approved people or groups.
2. Can I submit this form online?
No. You must print, sign, and mail, fax, or hand-deliver it.
3. Is the form only for veterans?
Mostly yes. But authorized family or legal representatives can also fill it with proper proof.
4. How often can I use this form?
You can use it anytime you want to release records. A new form is needed for each new request.
5. Does it cost anything to request records?
No. The VA does not charge for sending your medical records.