Daily Rules, Proposed Rules, and Notices of the Federal Government
a. Request for and Authorization to Release Medical Records or Health Information, VA Form 10-5345.
b. Individual's Request for a Copy of their Own Health Information, VA Form 10-5345a.
c. My HealtheVet (MHV)—Individuals' Request for a Copy of Their Own Health Information, VA Form 10-5345a-MHV.
d. Restriction of the Release of Individually-Identifiable Health Information through Nationwide Health Information Network (NwHIN), VA Form 10-0525a.
e. Request for and Authorization to Release Protected Health Information to Nationwide Health Information Network, VA Form 10-0485.
a. VA Form 10-5345 is used to obtain a written consent from patients before information concerning his or her treatment for alcoholism or alcohol abuse, drug abuse, sickle cell anemia, or infection with the human immunodeficiency virus (HIV) can be disclosed to private insurance companies, physicians and other third parties.
b. Patients complete VA Form 10-5345a to request a copy of their health information maintained at Department of Veterans Affairs.
c. VA Form 10-5345a-MHV is completed by individuals requesting their health information electronically through My HealtheVet.
d. VA Form 10-0525a is completed by individuals to restrict the sharing their electronic health information through the NWHIN.
e. VA Form 10-0485 is used to electronically exchange protected health information between VA and approved Nationwide Health Information Network participants.
An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The
a. VA Form 10-5345—10,000 hours.
b. VA Form 10-5345a—15,000 hours.
c. VA Form 10-5345a—MVH-35,000 hours.
d. VA Form 10-0525a—50 hours.
e. VA Form 10-0485—500 hours.
a. VA Form 10-5345—300,000.
b. VA Form 10-5345a—300,000.
d. VA Form 10-0525a—1,000.
e. VA Form 10-0485—10,000.
By direction of the Secretary.