VA Form – Authorization for Release of Information. Authorization for Release of Information. Effective date: June Downloads. VBA ARE. DEPARTMENT OF VETERANS AFFAIRS (VA). VA FORM. FEB Existing stocks of the VA Form , JAN , will be used. 1. LAST NAME. Use Form to authorize the release of medical and other information to the VA. The VA Forms Database>( .

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So to review, you send fill va form 21-4142 and send this form in for ANY now or in the future for any claims va form 21-4142 may have. I’ve always went to the same VAMC. After vx form is filled out you mail it to your VA Regional Office good idea is to mail registered with return receipt.

This may take a second or two.

You need this form for ANY claim. The first Section is used for general identification information. Its a good idea to get copies of your military medical records. I only need this form if I was va form 21-4142 outside of military treatment facilities or outside any VA hospital? Boxes 1, 2 and 4 are to be filled out with the veteran’s name, file number, and social security number.

This form must va form 21-4142 on file before Veterans Affairs can review any medical or disability claims.

The VA Form is available on the Veterans Affairs documentation website or can be supplied through a local Veterans Affairs office. Keep a copy on record, as you may need to submit additional consent forms if you fomr additional claims.

Thank you for the information. October 3rd,7: Fotm va form 21-4142 helps and good luck. That is, not send the form in but a separate sheet with dates and names of the VAMC. Va form 21-4142 submit your evidence with it doctors records from outside and or inside to support your claim. The form would be used primarily for V. October 2nd,8: October 1st,9: Just Firm Helping Vets. We’ve updated our Privacy Policy and by continuing you’re agreeing to the updated terms. You must include the name and addresses of all offices for which your medical or disability claim involves.

VA Form 21-4142 Authorization and Consent to Release Infomation FOR VA MEDICAL RECORDS?

I am not sure what STR’s are, maybe your military medical records, make reference to them, times, dates, conditions. You can also download the from from the internet via google search. In box 8, provide any additional comments about your consent that will be helpful for Veterans Affairs to seek your medical history and to vz va form 21-4142.

VA Form is the form you use to submit your claim for benefits. What is the purpose of this form? This is important as Veterans Affairs may need to contact you in regards to 211-4142 form and to further obtain your consent for additional information they need for processing your claims.

Members The team Contact us. Va form 21-4142 4th,3: November 20th,8: A couple va form 21-4142 years ago,I completed that form with V. You need this form if you were seen in or out of the military va form 21-4142 facilities.

I don’t need to send it in? Read all of the information and check the authorization box in box 9c. It will be pretty simple.

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Each time you submit a claim you fill one forn and send it in, or if you have multiple claims put them on this form. Wouldn’t my STRs support my claims? October 1st,2: Therefore, they could only grant one, as that would be “pyramiding” for both. November 21st,va form 21-4142 If you need more room on the form, use some 12-4142 pages and number them. A to obtain treatment records from any outside va form 21-4142 care providers.

November 21st, These boxes must be filled in. In box 10, the veteran, the claimant, or a legal representative must certify with their signature their consent of va form 21-4142 Va Form While this is not necessary for all medical records, Veterans Affairs for, need a witness statement when seeking some of your records.