Va medical records fax number Form 2021-2024

Va medical records fax number Form: What You Should Know

To make and receive a copy of the medical records to be received in this manner, you are asked to: Provide the name of the veteran. Provide the contact phone number. Provide the name and contact information of the individual to be served with the request. The requestor must be 18 years of age or older to receive this service. You may choose to make and receive a copy by phone or fax; however, it is the discretion of the health care facility on call and the individual to be served with the notice that they are responsible for scheduling a meeting with the designated person, and if you choose to request a copy, it is your responsibility to attend the appointment. Request or Transfer Records to/from VA — DIAGNOSTICS (Name and Address) FOR IMMEDIATE DETERMINATION AS TO THE PROSECUTION OF A VIOLATION AND THE FUTURE PENALTIES TO THE OFFENDER, YOU MAY USE ANY OF THE FOLLOWING TO APPLY TO THE FEDERAL BUREAU OF INVESTIGATION: VA Form 10-5345a (See Contact Information Below) MEDICAL RECORDS PROCESSING CENTER If your health information is requested, the records processing center may obtain a copy of these records based upon: The VA's Privacy Act Notice at 15 U.S.C. § 7014. VA's regulation at 21 C.F.R. Part 164, Part 165 and Part 168. For information about the Privacy Act, contact your local privacy office, the office of the Assistant Secretary for Planning and Evaluation at or the Federal Bureau of Investigation at . Filing This Form: Please send this form along with the following supporting documents. (Optional) (Optional: If you believe this request for disclosure is unlawful, you may print and mail copies of this form in compliance with the law.

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