Official VA Form

VA Form 21-4142

Authorization to Disclose Information to the Department of Veterans Affairs (VA)

VA Form 21-4142 — Authorization to Disclose Information to the Department of Veterans Affairs (VA) is an official U.S. Department of Veterans Affairs form used for disability, health care. The current version was last revised 2021-07-26. It is 5 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: 2021-07-26
First issued: 2023-05-25
Pages: 5
Administered by: VBA

DisabilityHealth care

Frequently asked questions

What is VA Form 21-4142 used for?

Authorization to Disclose Information to the Department of Veterans Affairs (VA). It is an official VA form in the Disability, Health care categories, administered by VBA.

Where can I download the current VA Form 21-4142?

Download the official PDF from VA.gov here: https://www.vba.va.gov/pubs/forms/VBA-21-4142-ARE.pdf (last revised 2021-07-26).

How long is VA Form 21-4142?

VA Form 21-4142 is 5 pages long, last revised 2021-07-26.

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

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More Disability forms

VA Form 21-4142a — General Release for Medical Provider Information to the Department of Veterans Affairs
VA Form 21P-0969 — Income and Asset Statement in Support of Claim for Pension or Parents' Dependency and Indemnity Compensation (DIC)
VA Form 21-0538 — Mandatory Verification of Dependents
VA Form 21-0845 — Authorization to Disclose Personal Information to a Third Party
VA Form VA9 — Appeal to Board of Veterans' Appeals
VA Form 21-4192 — Request for Employment Information in Connection with Claim for Disability Benefits
VA Form 21P-8416 — Medical Expense Report
VA Form 21-0781 — Statement in Support of Claim for Service Connection for PTSD

Nearby form numbers

VA Form 21-2680 — Examination for Housebound Status or Permanent Need for Regular Aid and Attendance
VA Form 21-4138 — Statement in Support of Claim
VA Form 21-4140 — Employment Questionnaire
VA Form 21-4142a — General Release for Medical Provider Information to the Department of Veterans Affairs
VA Form 21-4170 — Statement of Marital Relationship
VA Form 21-4192 — Request for Employment Information in Connection with Claim for Disability Benefits