10-5345
Request for and Authorization to Release Health Information
- Agency
- VA
- Revision
- 2026-05-05
- Fillable fields
- 61
10-5345
Form 10-5345: Request for and Authorization to Release Health Information
Use VA Form 10-5345 to authorize us to share your health information with a non-VA (or third-party) individual or organization.
How to fill out Form 10-5345 online
- 1
Open the form
Press Fill 10-5345 online. The official form opens in your browser, ready to type into.
- 2
Fill in the fields
Click a field and type. Move through the form at your own pace, nothing is sent anywhere until you choose.
- 3
Download or print
Save the filled form as a PDF or print it. You do not need an account to download it.
Why fill Form 10-5345 on indox
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
- Fill the form right in your browser, no software to install
- Free to fill and free to download, with no account
- The official blank straight from the VA, not a copy someone retyped
- Works on a phone, tablet or computer
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