Get Omb Number: 2900-0260

Filling out the OMB Number: 2900-0260 is essential for authorizing the release of medical records or health information. This guide offers a step-by-step approach to help users complete the form accurately online.

Follow the steps to complete the OMB Number: 2900-0260 form successfully.

1. Click the ‘Get Form’ button to obtain the form and open it in your document editor.
2. Enter the patient's name and Social Security Number if the patient's data card imprint is not used. This is crucial for accurately identifying the individual whose records are being requested.
3. Provide the date of birth to further verify the patient’s identity. Enter it in the designated field.
4. Specify the name and address of the organization or individual to whom the health information is being released. Ensure all details are accurate to avoid miscommunication.
5. Indicate the veteran's request by checking the appropriate boxes related to the conditions for which information is being authorized for release, such as alcoholism or drug abuse.
6. Fill out the information requested section by checking applicable boxes and providing additional details about the nature of the information, like copies of hospital summaries or outpatient treatment notes.
7. State the purpose for which the information will be used by the individual receiving the records, ensuring it aligns with the veteran's needs.
8. Complete the authorization section by certifying that the request is voluntary, accurate, and complete. Sign and date the form as required.
9. After filling in all necessary fields, save your changes. You can then download, print, or share the completed form as needed.

Complete your documents online now to ensure a smooth release of medical records.