Official VA Form

VA Form 10-252

Authorization to Release Protected Health Information to State/Local Public Health Authorities

VA Form 10-252 — Authorization to Release Protected Health Information to State/Local Public Health Authorities is an official U.S. Department of Veterans Affairs form used for health care, records. The current version was last revised 2020-11-05. It is 1 page long. Download the up-to-date PDF below — BaseNeed syncs form data directly from VA.gov so you always get the current edition.

Download the official PDF (VA.gov) →

Last revised: 2020-11-05
First issued: 2022-12-05
Pages: 1
Administered by: VHA

Health careRecords

Frequently asked questions

What is VA Form 10-252 used for?

Authorization to Release Protected Health Information to State/Local Public Health Authorities. It is an official VA form in the Health care, Records categories, administered by VHA.

Where can I download the current VA Form 10-252?

Download the official PDF from VA.gov here: https://www.va.gov/vaforms/medical/pdf/10-252%20Authorization%20To%20Release%20Protected%20Health%20Information%20To%20State%20Local%20Public%20Authorities.pdf (last revised 2020-11-05).

How long is VA Form 10-252?

VA Form 10-252 is 1 page long, last revised 2020-11-05.

Always the current version — synced from VA.gov. BaseNeed is not affiliated with the U.S. Department of Veterans Affairs.

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