Get VA 10-5345 2003
of Information Unit at the facility housing the records. Redisclosure of my medical records by those receiving the above authorized information may be accomplished without my further written authorization and may no longer be protected. Without my express revocation, the authorization will automatically expire: (1) upon satisfaction of the need for disclosure; (2) on ________________ (date supplied by patient); or (3) under the following conditions(s): I understand that the VA health care prac.
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