Follow the steps to fill out the VA 10-5345a form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your date of birth in the specified format (mm/dd/yyyy). This is essential for identifying your records accurately.
3. Next, fill in your last name, first name, and middle name, as this information is necessary for the VA to process your request.
4. Provide your mailing address, including city, state, and zip code to ensure the delivery of your health information.
5. In the 'Description of Information Requested' section, check the applicable box(es) that describe the specific health information you are requesting. Be as detailed as possible to facilitate the retrieval of your records.
6. If you have selected specific clinics or providers, include their names and the corresponding date ranges to narrow your request.
7. Indicate how you would like to receive the health information by selecting from the options: Paper, CD-ROM, or other methods.
8. If you choose an in-person pick-up, ensure to provide a contact phone number so that they can reach you regarding the collection of your information.
9. You can opt to have the information mailed to the same address provided above or enter a new address if applicable.
10. Finally, sign the form in ink, include the date of signing, and if someone else is signing on your behalf, indicate the authority under which the request is made.
11. Once you have completed the form, you can save changes, download, print, or share the form as needed.

Complete your VA 10-5345a form online to request your health information today.