Dec 18, 2025 · Use VA Form 21-4142 to give us permission to obtain your personal information from a non-VA source like a private doctor or hospital. Examples of personal information may …

INSTRUCTIONS: Before completing this form, read the Privacy Act and Respondent Burden on page 2. Use this form to provide your written authorization to obtain your treatment records, so …

Feb 21, 2025 · That’s where VA Forms 21-4142 (Authorization to Disclose Information) and 21-4142a (General Release for Medical Provider Information) come into play. These forms …

Apr 4, 2023 · VA Form 21-4142, also known as the Authorization to Disclose Information to the VA, is a form that permits the release of a veteran’s records to the VA from non-VA sources, …

INSTRUCTIONS: Before completing this form, read the Privacy Act and Respondent Burden on page 2. Use this form to provide your written authorization to obtain your treatment records, so …

The VA will not deny an individual benefits for refusing to provide his or her SSN unless the disclosure of the SSN is required by Federal Statute of law in effect prior to January 1, 1975, …

Dec 14, 2025 · VA Form 21-4142 is officially known as the “Authorization to Disclose Information to the Department of Veterans Affairs.” In plain English, this document acts as a permission …

Nov 16, 2022 · VA Form 21-4142 is a document that the United States Department of Veterans Affairs must have on file before it can review your medical claim. You can download the form …

Dec 18, 2025 · Use VA Form 21-4142 to give us permission to obtain your personal information from a non-VA source like a private doctor or hospital. Examples of personal information may …