![]() This is to ensure your personal health information is safe and protected. The VA follows strict security policies and practices. Your VA health record is the official and authoritative record for the VA. Additionally, you will have access to your information from other sources as it becomes available.Ĭopies of select portions of your VA health record may be viewed in My Health eVet. As an authenticated user, you will be able to view copies of key portions of your electronic VA health record. This provides a level of security that protects your information. Some Veterans may view portions of their Department of Defense Military Service Information.Īuthentication is a process to verify the Veteran's identity. It enables Veterans to create and maintain a PHR that includes access to health education information, personal health journals, copies of key portions of VA patients' electronic health records, and electronic services such as online VA prescription refill requests, Secure Messaging and more. My Health eVet is an online Personal Health Record (PHR). Failure to furnish the information will not have any affect on any other benefits to which you may be entitled. However, if the information including Social Security Number (SSN) (the SSN will be used to locate records for release) is not furnished completely and accurately, VA will be unable to comply with the request. Your disclosure of the information requested on this form is voluntary. The information on this form is requested under Title 38, U.S.C. The purpose of this form is to provide an individual the means to make a written request for a copy of their information maintained by the Department of Veterans Affairs (VA) in accordance with 38 CFR 1.577. This includes the time it will take to read the instructions, gather the necessary facts and fill out the form. We anticipate that the time expended by all individuals who must complete this form will average 2 minutes. We may not conduct or sponsor, and you are not required to respond to, a collection of information unless it displays a valid OMB number. The Paperwork Reduction Act of 1995 requires us to notify you that this information collection is in accordance with the clearance requirements of section 3507 of the Act. PRIVACY ACT AND PAPERWORK REDUCTION ACT INFORMATION ![]() INDIVIDUALS' REQUEST FOR A COPY OF THEIR OWN Landlord (Tenant) Recommendation Letter. ![]() We cannot look at or reveal your information, thus be sure it is safe. ![]() This should save you from possible future issues. Type in the requested information in the section LAB RESULTS, SPECIFIC TESTS Name Date, DATE RANGE, RADIOLOGY REPORTS Name Date, LIST OF ACTIVE MEDICATIONS, VACCINATION Dose Lot Number Date, LEGAL HEALTH RECORDS FOR TORTS, OTHER Describe, COPY OF HEALTH INFORMATION IS TO, PAPER, CDROM, OTHER, INPERSON PICKUP PROVIDE CONTACT, MAIL TO, and SAME ADDRESS AS ABOVE. The PDF form you are about to complete will consist of the following segments: You may use our multifunctional toolbar to include, remove, and change the text of the form. Step 2: Now you may enhance your Va Form 10 5345A. ![]() Step 1: Click the button "Get Form Here". Since you comply with the following steps, the procedure for creating the Va Form 10 5345A form is going to be easy. The PDF editor was designed to be so simple as it can be. ![]()
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