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  • Na Form 13042 - Request For Information Needed To Locate Medical ...

Get Na Form 13042 - Request For Information Needed To Locate Medical ...

F medical records from the National Clinical (inpatient) records for a military service member, a military retiree, or a dependent of an active/retired military member for hospitalization in a military medical treatment facility. Outpatient records for a military retiree, a dependent of an active/retired military member, a civilian Federal employee, or a dependent of a civilian employee for outpatient treatment in a military medical treatment facility. WHEN NOT TO USE THIS FORM:.

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To request clinical and medical treatment records: When sending a request via postal mail or fax, please use the NA Form 13042, Request for Information Needed to Locate Medical Records. Although not mandatory, using the NA Form 13042 is the recommended method to send a request for medical records/information.

Civilian medical records are private. Doctor-patient confidentiality. The military can't look at civilian medical records without your consent or a court order.

When sending a request via postal mail or fax, please use the NA Form 13042, Request for Information Needed to Locate Medical Records. Although not mandatory, using the NA Form 13042 is the recommended method to send a request for medical records/information.

NA Form 13038, Certification of Military Service for the National Archives and Records Administration.

Depending on your health history and dates of service, the VA may access your DoD electronic health record. Before you leave military service, request paper copies of your health record and your family members' health records.

The purpose of the information on this form is to assist the National Personnel Records Center in locating the correct medical record(s) or information to answer your inquiry.

How to fill out a health or medical record release form Patient information. Whose health records do you want? ... Clinic, hospital, care provider. ... Date of Services. ... Information to be released. ... Receiving party or destination of records. ... Purpose of release. ... Expiration date or duration of consent. ... Release instructions.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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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