VA Form 21-4142
Authorization to Disclose Information to the VA
Your permission slip letting the VA collect records from private, non-VA doctors.
Opens the official VA.gov page, always the authority on the current version and instructions.
The VA can pull its own medical records automatically, but private hospitals and clinics need your signed authorization. This form (with its companion 21-4142a listing the providers) is how the VA requests private treatment records for you.
Many veterans instead gather private records themselves so they can review what goes in; either path is valid.
Worth knowing
- Companion form 21-4142a lists each provider, their address, and treatment dates.
- Authorizations expire; the VA uses them only for the claim at hand.
On this site
Keep your copy where you can find it
Every form you send becomes part of your story. MusterVault keeps your completed copies, decision letters, and records organized and encrypted on your own computer, so the next deadline finds you ready. No cloud, no account.
Informational only: what this form is and where it lives, not advice about whether or when to file it. A free accredited VSO can advise on your situation. MusterVault organizes records, never gives claims advice, and is not affiliated with the U.S. Department of Veterans Affairs.