2025 Printable Template
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Form last updated: 03/2024. Please verify this is the current version before use.
Easily complete & submit your VA 10-10172 form
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What is a VA 10-10172 used for?
VA Form 10-10172 is used by veterans to request and authorize the release of their medical records. This form facilitates the secure sharing of medical information with authorized parties, such as healthcare providers or representatives, for purposes like ongoing medical care or personal records management.
Who needs to fill out a VA 10-10172 form
Veterans or their representatives who need to authorize the release of medical records.
How to fill out a VA 10-10172 online?
Follow these steps to complete your VA 10-10172 form online.
Frequently Asked Questions
Find quick answers to common questions about our PDF editor.
It is a form used to request and authorize the release of medical records for veterans.
You can submit the form by mail or electronically through the HealthShare Referral Manager.
You should submit a corrected version of the form using the same submission method.
