When to use this form
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Use VA Form 21-4142 to give us permission to obtain your personal information from a non-VA source like a private doctor or hospital. Examples of personal information may include your medical treatment, hospitalizations, psychotherapy, or outpatient care.
Downloadable PDF
Download VA Form 21-4142 (PDF)
Helpful links related to VA Form 21-4142
21st Amendment
Get your VA medical records online
Securely view, download, and share your medical records.
How to file a VA disability claim
Learn about the steps for filing a claim for disability compensation or increased disability compensation.
File a Supplemental Claim
Learn about filing a Supplemental Claim and adding new evidence to support your case.