Get Va Form 10-5345 - Spadea & Associates, Llc

Filling out the VA Form 10-5345 is an essential step for individuals seeking to authorize the release of their medical records or health information. This guide provides clear and structured instructions to assist users in completing the form online effectively.

Follow the steps to accurately fill out the VA Form 10-5345.

1. Click the ‘Get Form’ button to acquire the document and open it in a convenient format for editing.
2. Begin by entering the patient's full name and Social Security Number if the patient data card imprint is not being used. This information is crucial for identifying the records that need to be released.
3. Provide the name and address of the healthcare facility receiving the information. For example, you may write: 'Coatesville VA Medical Center, 1400 Black Horse Hill Rd., Coatesville.'
4. Specify the organization or individual to whom the information is to be released, ensuring you include all necessary details for accurate communication.
5. Indicate the conditions for which information is to be released by checking the applicable boxes. Users should clearly state the extent or nature of the requested information and provide dates covering the information required.
6. Complete the purpose or need for which the information is being shared, for example, 'Coordination and facilitation of treatment services for Justice-involved Veterans.'
7. Read the authorization section carefully. Here, you certify that the request has been made voluntarily and all information provided is complete and accurate. Sign and date the form.
8. Finally, save your changes, and download or print the completed form for your records. Ensure you share it with the relevant parties as needed.

Start completing your VA Form 10-5345 online now to ensure your medical records are released efficiently.