VA Form 10-5345

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The VA form 10-5345 is a specific form that is meant to provide access to medical records of veterans once they are in the need of medical intervention. The document allows doctors and other healthcare providers to lawfully collect and access medical records of veterans when they are not in active duty anymore.

One of the conditions of using this form is that a veteran should have been treated at any of the veterans’ medical facilities during their active duty. Then, the doctors who treated the veteran in those facilities can use this form to get information about their former patient and follow-up on their treatment.

The full name of the form is the Request for and Authorization to Release Health Information.

Why Do Veterans Need a Specific Form?

In the same way as with any other people, veterans’ medical records are used to record any treatments that a person got. But not everyone can access this information, which is why the Veterans Affairs form needs to be used to give authorizations to a defined circle of persons.

There are certain circumstances when there is a need for the VA form 10-5345.

  • The most common way to use the veterans affairs form is to follow-up on the patient’s treatment. This happens after the patient was given certain medical care and their doctor or another healthcare provider wants to know what their health condition is after the treatment.
  • Another situation when the form might be needed is when the health practitioner needs to get acquainted with the past medical records of a veteran in order to make references for the future. The doctors are the ones who are expected to make serious decisions about the patient’s treatment, which is why they might need to learn their medical records to be prepared to make such decisions once there is a need in them.

How to Fill Out a VA Form 10-5345

First of all, you need to find a proper VA form. The one presented on the website of the US Department of Veteran Affairs might be your form to choose. Or you can avoid searching the internet and use the VA form that you can find on our website. After you download the form, you have to thoroughly read the Privacy Act at the beginning of the document, which touches on the ethos of using VA forms.

Then, you can start filling in the information about the patient, authorized people or organizations, and the type of information to be released.

Step 1 – The patient’s information

The first information to include in the form is the name and address of the healthcare facility. Then, include the name and address of the patient plus their mailing address.

Step 2 – Persons/entities who will get access to the information

Next, the name of the organization to which the information will be disclosed should be mentioned. If the patient wishes to authorize individuals to access their medical records, the names of those people plus their titles should be written.

Step 3 – The purpose

The purpose of releasing information is what should be included next. It might tell that the information will be used by the requestor for treatment, to provide health benefits, for employment purposes, etc.

Step 4 – What information is requested

When using the form provided by the US Department of Veteran Affairs, one will have to check the boxes with the data that the patient wants to release. The duration of the release should be provided in front of each of the chosen boxes.

Step 5 – Sensitive diagnoses

The next section should touch on the release of the information regarding non-treatment purposes. It includes information about drug or alcohol abuse, HIV, etc.

Step 6 – Authorization

The patient should carefully read the Authorization section with the information about the revocation of the authorizations and other important aspects of using the form.

Step 7 – Expiration

The document should include the information on the date when it will automatically expire.

Step 8 – Signatures

The last step is to put the patient’s signature. If the patient is unable to sign the document, their legal representative’s signature and relation to the patient need to be included. The date of signing the document should be written down as well.

There will be the only section in the document that should be left blank. It is the last section of the document that is filled by the Veterans Administration.