VAFORMS.NET – VA Form 10-0527 – Request and Authorization to Release Protected Health Information to the Choice/PC3 Program – Whenever you apply for VA benefits, you must fill out VA Form 10-0527. The purpose of this form is to obtain information about your medical eligibility. This information is used to verify eligibility using a computer matching program. If you fail to provide the information, you may have your health care benefits delayed. However, your other benefits won’t be affected. The Social Security number you provide is necessary for the administration of your benefits by the VA. It may also be used for other purposes.
Download VA Form 10-0527 – Request and Authorization to Release Protected Health Information to the ChoicePC3 Program
| Form Number | VA Form 10-0527 – |
| Form Title | Request and Authorization to Release Protected Health Information to the Choice/PC3 Program |
| Edition Date | March 2022 |
| File Size | 1 MB |
The information you include on VA Form 10-0527 must be accurate and detailed, as the Department of Veterans Affairs will verify all of the information. This includes your personal information, employment experience, and references. The more specific information you provide, the better your chances of qualifying for the program. You can also attach a separate sheet of paper to add additional space.
Where Can I Find a VA Form 10-0527?
If you’re considering a VA benefit, you may wonder where to find VA Form 10-0527. This form is used to update information such as insurance and personal details. The form is available at the Health Eligibility Center, 2957 Clairmont Road, Suite 200, Atlanta, GA 30329. By completing the form, you agree to pay VA copayments for health care services and products and to receive communication from the VA. However, providing your contact information is entirely voluntary.
VA Form 10-0527 – Request and Authorization to Release Protected Health Information to the Choice/PC3 Program
The VA Form 10-0527 – Request and Authorization to Release Protected Health Information to the Choice/PC3 Program must be completed and signed by the veteran and any witnesses. The application cannot be processed unless it is signed properly. There are three parts to the form: section I, section II, and section III. All applicants must complete sections I and II. In addition, the application requires all applicants to agree to pay co-payments for VA health care and to receive communication from the VA.
The application also requests a copy of personal health records from the Department of Defense. The information may be electronic, but it is advisable to get hard copies of the records. The application should include information about all health insurance coverage plans and the health insurance coverage through your spouse. It is recommended that you bring the insurance cards to the appointment to prove that you are insured.
VA Form 10-0527 Example
