Official VA Form

VA Form 10-5345

Request for and Authorization to Release Health Information

VA Form 10-5345 — Request for and Authorization to Release Health Information is an official U.S. Department of Veterans Affairs form used for health care. The current version was last revised 2021-07-19. It is 2 pages 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: 2021-07-19
First issued: 2023-10-18
Pages: 2
Administered by: VHA

Health care

Frequently asked questions

What is VA Form 10-5345 used for?

Request for and Authorization to Release Health Information. It is an official VA form in the Health care category, administered by VHA.

Where can I download the current VA Form 10-5345?

Download the official PDF from VA.gov here: https://www.va.gov/vaforms/medical/pdf/VA_Form_10-5345_Fillable.pdf (last revised 2021-07-19).

How long is VA Form 10-5345?

VA Form 10-5345 is 2 pages long, last revised 2021-07-19.

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

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Nearby form numbers

VA Form 10-5018 — Petty Cash Receipt
VA Form 10-5023 — Receipt for Miscellaneous Collections
VA Form 10-5096 — Request For Service or Article (VCS)- Fillable
VA Form 10-5345a — Individuals' Request for a Copy of Their Own Health Information
VA Form 10-5379a — Special Pay Agreement
VA Form 10-5379e — Special Pay Computation - Physicians and Dentists