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  • Va Form 10 0431a

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Department of Veterans Affairs Veterans Health Administration Washington, DC 20420 VHA HANDBOOK 1004.01 Transmittal Sheet August 14, 2009 INFORMED CONSENT FOR CLINICAL TREATMENTS AND PROCEDURES 1.

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Emergent and urgent prescriptions filled at non-CCN retail pharmacy locations must be paid for when the prescription is filled. You may submit a request for reimbursement of that cost to your local VA medical facility Community Care office. Use the VA Facility Locator to find the closest VA medical facility.

Use VA Form 21-4142 to give us permission to obtain your personal information from a non-VA source like a private doctor or hospital. Examples of personal information may include your medical treatment, hospitalizations, psychotherapy, or outpatient care.

VA Form 3288, REQUEST FOR AND CONSENT TO RELEASE OF INFORMATION FROM INDIVIDUAL'S RECORDS.

Nonexpendable personal property becomes accountable nonexpendable personal property if its acquisition cost is at or above $5,000, is sensitive in nature, or is capitalized personal property.

Use VA Form 21-4502 if you're a Veteran with a disability and you want to apply for compensation for a vehicle that meets your needs. This may include a specially equipped vehicle for you to drive or adaptive equipment to help you get in and out of your vehicle.

Use VA Form 10-5345 to authorize us to share your health information with a non-VA (or third-party) individual or organization.

When to use this form. Use VA Form 21-4138 when you want to submit a VA “buddy statement” or other statement from someone with firsthand knowledge of information you believe will help support your request for VA benefits.

Use VA Form 10-5345 to authorize us to share your health information with a non-VA (or third-party) individual or organization.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232