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Disclaimer: Add Scope of Practice Information Hear and Use of Medical Information Access, HIPPA compliant access and authorization and how it will be used to stay with in scope and assist in supporting the patient in adhering to the care plan outlined by his medical provider. 

Forms to Download 

Department of Veterans Affairs

Request for and Authorization to Release Health Information Form VA Form 10-5345

For use at US Military Treatment Facilities 

Authorization for Disclosure of Medical or Dental Information