VAFORMS.NET – VA Form 10-0525a – Restriction of the Release of Individually-Identifiable Health Information Through eHEALTH Exchange – This article discusses the VA Form 10-0525a – Restriction of the Release of Individually-Identifiable Health Information Through eHEALTH Exchange. It explains what a Restriction of Release of I form is and where to find it. It also provides tips on how to fill it out. You can download a copy from the VA website.
Download VA Form 10-0525a – Restriction of the Release of Individually-Identifiable Health Information Through eHEALTH Exchange
| Form Number | VA Form 10-0525a |
| Form Title | Restriction of the Release of Individually-Identifiable Health Information Through eHEALTH Exchange |
| Edition Date | March 2022 |
| File Size | 790 KB |
What is a VA Form 10-0525a?
Form 10-0525a is used to restrict electronic health information exchange between VA and approved Nationwide Health Information Network (NWHIN) participants. It is also used to request copies of health information about an individual. It is issued by the VA and has an issue date of 05/06/2005.
The form must be completed in full. It has a number of checkboxes that require specific information. It also contains instructions. This can take a couple of minutes. The form must be filled out and signed. For more information about filling out this form, visit the VA website.
If you have an appointment with a VA provider and you are planning to seek care elsewhere, you should update your preference in VA health records. The government wants to share health information with providers outside of the VA. If you do not want to share your medical information with others, you must opt-out of the Veterans Health Information Exchange.
Where Can I Find a VA Form 10-0525a?
The VA Form 10-0525a is used to restrict the sharing of electronic health information between the VA and approved Nationwide Health Information Network (NWHIN) participants. This form was last updated on May 6, 2005. This form should be completed by the individual requesting a copy of their health information.
If the veteran was receiving VA benefits at the time of his or her death, he or she may qualify for VA Pension benefits. To claim these benefits, a veteran must have a DD214 or death certificate and submit VA Form 21-530. In addition, the veteran must also submit an itemized list of funeral expenses as well as a paid receipt from the funeral home. The form can be submitted online or to a financial institution.
Veterans who don’t want to have their health information shared may opt out. They can complete VA Form 10-10164 to restrict the sharing of their medical information. Those who have previously opted out of VA sharing must resubmit the form.
VA Form 10-0525a – Restriction of the Release of Individually-Identifiable Health Information Through eHEALTH Exchange
The VA Form 10-0525a – Restraint of the Release of I (or Form 10-0525a-R) is a form used to obtain written patient consent to release protected health information. This form is necessary when the information contained in the record is sensitive and covered under HIPAA statutes. It is also used to obtain consent when an individual requests copies of their medical records. This new form is part of a Program Change and reduces the burden of the form for the health care provider. The form takes less than three minutes to complete and complies with 5 CFR 1320.8(b)(3).
Before, veterans had to opt-in to allow the VA to share their medical records with other providers. However, as part of the 2018 MISSION Act, veterans will have the option to opt-out. If they do not wish to share their health records, they should submit VA Form 10-10164 to the Release of the Information office of their VA medical facility.
VA Form 10-0525a Example
