VA Form 10-5345a requests a copy of your own VA health information for delivery to you. Use it when you want to read your treatment notes, assemble records for a disability claim or check what a VA clinician documented. 10-5345, without the final letter, authorizes VA to send health information to someone else.

Download the current VA Form 10-5345a PDF

Download the official July 2021 VA Form 10-5345a PDF from VA's form page. I checked the current download on October 2, 2026. It is one page, and its fields are unnumbered. This guide follows their printed order.

The form's two main decisions are what records you want and how you want to receive them. Selecting the prior-two-year health summary is a different request from asking for older notes or a complete treatment record.

Choose 10-5345a or 10-5345 based on the recipient

VA's Privacy Act guidance distinguishes personal access from third-party disclosure:

  • Use 10-5345a when the copy goes to you. You can review it yourself and decide which records to share afterward.
  • Use 10-5345 when VA will send the records directly to an outside person or organization. That authorization identifies the recipient, purpose and expiration, with additional instructions for sensitive diagnoses.

For a claim, either route may serve a different preparation task. Requesting your own notes lets you check dates and find missing records. Authorizing delivery to an outside clinician lets that clinician receive the specified VA records for a review. Neither request is the disability application itself.

A C-file request is another task. VA Form 20-10206 requests military or benefits records, including the file VA maintains for your claims. Do not assume a treatment-record request to your hospital produces every rating decision or disability examination in the benefits file. Use VA's 20-10206 page when that is what you need.

Similarly, service treatment records document military care. They are not simply another name for records of VA treatment after service. Identify which source holds the period you are trying to document.

Top fields: Tell VA whose records and which facility

To: Department of Veterans Affairs. Enter the name and location of the VA health care facility holding the information. Use the facility where you received care. If treatment occurred at an outpatient clinic, VA recommends checking with the records office about whether it holds those records.

Last name, first name, middle name. Enter your name in the printed order. A person assisting you should not put their own name here.

Date of birth. Use month/day/year. Together with your name, it helps VA identify the right health record. This edition does not have a Social Security number field.

Patient's mailing address. Provide your current street address, city, state and ZIP code. Later, the form asks whether delivery should use this address or a different one. Completing the first address does not automatically select a delivery method.

Check these fields against the request you intend to make. The form's privacy notice explains that incomplete or inaccurate information needed to locate the records can prevent VA from completing it.

Description of information requested: Work down the list

The July 2021 PDF allows more than one selection. Use the accompanying lines to explain the dates, provider or procedure involved.

Health summary, prior two years. Select it when that summary is what you want. It is a limited summary option, not a request for every record since enrollment.

Inpatient discharge summary. Enter the dates of the hospitalization you are identifying. A discharge summary and the underlying daily notes are different documents; describe both if you need both.

Progress notes. The form offers three ways to specify them: particular clinics with date ranges, particular providers with date ranges, or a date range. You might identify a treatment specialty rather than trying to remember every clinician's name. Be clear about the beginning and ending dates you want searched.

Operative or clinical procedures. Enter the procedure name and date. If the exact name is unfamiliar, describe the procedure accurately enough for the records office to identify it and ask the office about any uncertainty.

Lab results. Identify specific tests and their dates, or use the date-range line. This field requests the results already in your record; it does not order new testing.

Radiology reports. Name the examination and date. Reports contain the written interpretation. If you need the images as well, state that in “Other” and ask which delivery format the facility supports.

List of active medications. Select this if you need the current list. If you want a medication history covering an earlier period, describe that additional request under “Other.”

Vaccination. Identify the dose, lot number, date and location information requested by the field as available. Make the specific record you need clear.

Legal health records for torts. This is a distinct printed category. It is not the usual selection merely because you are preparing a VA disability claim. If your request concerns a tort matter, confirm the scope with the records office or your legal representative.

Other. Describe records not covered by the listed options. Unlike the May 2026 10-5345, this edition has no separate general “patient medical records” checkbox. If you need the complete record for a defined period, state that request here and identify the period rather than relying on the summary box.

Delivery: Choose the format and destination

The next section says the copy will be delivered to the individual. Choose paper, CD-ROM, or other, describing the requested alternative. Confirm that you can use the chosen format and that the facility can provide it.

For in-person pickup, check the box and provide the contact telephone number. VA's facility-records instructions say to bring valid photo identification when you go in person, such as a driver's license or Veterans Health Identification Card.

For mail delivery, choose the same address as above or provide the new address in the space below. The new-address field changes where your copy is delivered. It does not replace the third-party authorization process when your intent is for VA to disclose the records to another person.

Before signing, compare the format and delivery choices. A selected CD-ROM option without a clear pickup or mailing choice leaves an avoidable question for the records office.

Signature and another person's authority

Sign in ink and enter the date in month/day/year format. The note beneath the signature says that someone signing for the individual must indicate the authority under which the request is made, such as guardianship or power of attorney.

A helper can assist with the fields without becoming the authorized signer. If another person needs to sign, ask the records office what documentation it needs for that authority. The form does not include the recipient, expiration and sensitive-diagnosis sections that appear on 10-5345; do not add those older form instructions to this one.

Fictional example: Request older notes for your own review

This is a fictional form exercise. It describes no real person, treatment history or disability claim, and supplies no personal identifiers.

An unnamed veteran wants copies of VA physical therapy notes from January 1, 2018, through December 31, 2020, plus a radiology report dated October 15, 2019. The veteran will read the records before meeting with an accredited representative.

The entries would be organized this way:

  • Facility: The VA health system holding those physical therapy and radiology records.
  • Patient information: The veteran's own name, birth date and address.
  • Progress notes, specific clinics: Physical therapy, January 1, 2018, through December 31, 2020.
  • Radiology reports: The relevant examination name and October 15, 2019 date.
  • Format: Paper, if that is the veteran's preferred usable format.
  • Mail to: Same address as above, after checking that it is current.
  • Signature: The veteran's ink signature and actual signing date.

The prior-two-year summary would not describe those older dates. If the veteran instead wanted VA to send the records directly to the outside representative, the appropriate third-party disclosure process would use 10-5345.

Where to submit it, including the online alternative

VA's current medical-records page provides these routes:

  • Online: Send a secure message describing the records to a care team at the treating facility with “Release of Information” in its name. VA says it will acknowledge the message within three business days and explain the next steps. That is acknowledgment, not a three-day promise to deliver the records.
  • Mail: Send the signed 10-5345a to the treating facility's Release of Information mailing address.
  • Fax: Send it to that office's published fax number.
  • In person: Bring it to the medical records office with valid photo identification.

There is no national 10-5345a mailing address or fax number on the form. Find your facility through VA's location finder, then select Other services and Access your health records for local contact details. If no Release of Information team appears in secure messaging, use the facility's mail, fax or in-person route.

Many personal records are also available through My HealtheVet, as VA explains in its records-request overview. A download can help with records already available online; a facility request lets you specify records you have not found there.

What to check before and after the request

Before sending, check the facility, patient identity, record categories, dates, format, destination and signature. Keep a copy of the request and any message acknowledgment or delivery receipt.

When the records arrive, compare them with that list. Check the earliest and latest dates, the clinics represented and any separately requested reports. If something is missing, tell the records office precisely which part of the original request remains unanswered. A package arriving does not establish that every requested record was included.

For claim preparation, Claim Raven's Evidence Checklists gives you a place to track the condition-specific evidence you are gathering and add notes about remaining gaps. The tool records your progress; you still review what the documents actually say.

If a treatment note raises a question about evidence requirements, Ask Raven can explain VA claim questions with linked sources. A free account includes starter messages. Use the answer to identify a question to investigate in your records or discuss with your representative.

For representation, see our 21-22 and 21-22a walkthrough. For a Supplemental Claim supported by additional evidence, see 20-0995. Obtaining records and submitting the appropriate claim or review remain separate tasks.

Verified October 2, 2026: the official form page, the one-page July 2021 PDF, VA's facility-request and privacy guidance, and linked Claim Raven pages. The example is fictional. A specific facility's delivery formats, mailing address and fax must be checked with that facility.

Where to go next

Claim Raven is data analysis, not legal, medical, or VA-accredited advice. Ask your VA records office about access requirements and an accredited representative about using records in your claim.

-Landon Founder, Claim Raven | U.S. Army Veteran