Supplemental Statement for VA Form 21-4142a, General Release for Medical Provider Information to the Department of Veterans Affairs (VA):
VA has newly created the VA Form 21-4142a, General Release for Medical Provider Information to the Department of Veterans Affairs (VA). The new VA Form 21-4142a is created to gather PHP information from the claimant and is filled out in conjunction with the VA Form 21-4142 as this form does not require a signature. It is solely used by VA to gather information to be used to develop for private medical records.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | White, Kayce, VBAVACO |
| File Modified | 0000-00-00 |
| File Created | 2021-01-27 |