VA Form 10-5345a: Individuals' Request for a Copy of Their Own Health Information
VA Form 10-5345a is the request form Veterans use to get copies of their own VA health records, whether on paper, on disc, or in another available format.
This is the genuine VA PDF, unmodified. Source: VA official page.
What is VA Form 10-5345a?
You have a right to a copy of the health information VA keeps about you. VA Form 10-5345a puts that request in writing: it identifies you, the records you want, the date ranges, and how you would like to receive them.
The form goes to the Release of Information office at the VA facility that treated you. Many Veterans can also view and download much of their record through the My HealtheVet tools on VA.gov, which can be faster for routine needs like recent lab results or visit notes.
Who files VA Form 10-5345a?
- Veterans who want paper or electronic copies of their VA treatment records
- VA patients gathering records for a disability claim, private provider, or personal files
- Individuals requesting specific record types, such as imaging, lab results, or progress notes
- Personal representatives with legal authority requesting records on a patient's behalf
How to fill out VA Form 10-5345a
- Decide which records you need and the date ranges; narrower requests are usually filled faster.
- Complete your identifying information, including your Social Security number and contact details.
- Specify the types of records requested and your preferred format, such as paper or CD.
- Sign and date the request.
- Submit it to the Release of Information office at the VA medical center or clinic that holds the records, in person or by mail.
Quick fill VA Form 10-5345a on this page
Prefer to see the form itself while you type? Open VA Form 10-5345a in the editor to fill it on the actual pages, add a signature, and download.
Frequently asked questions
Does it cost anything to get my VA records?
VA generally provides copies of your own records at no charge for typical requests, though fees can apply in some cases for very large requests. Ask the Release of Information office about any charges before they process it.
Can I get my records online instead?
Often, yes. The My HealtheVet portal on VA.gov lets you view and download much of your VA health record, including the VA Blue Button report. Use the 10-5345a when you need official copies, older records, or items not available online.