U.S.Army Medical Records Release Form

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Request Copies of Medical Records

https://tricare.mil/Resources/MedicalRecords/RequestingRecords

If it's been more than two years since your last appointment, you’ll need to request copies of your records from the archives. From Civilian Providers. You must …

Request your military service records (including DD214)

https://www.va.gov/records/get-military-service-records/

Follow these steps to submit a military records request. From your signed-in homepage, click or tap on Correspondence/ Documentation. Then select Defense …

My Military Health Records | TRICARE

https://tricare.mil/Resources/MedicalRecords

Not all medical organizations participate in the eHealth Exchange to share your medical records. The jHIE is now available at several sites around the U.S. …

REQUEST AND RELEASE OF MEDICAL …

https://armypubs.army.mil/pub/eforms/DR_a/pdf/A4876.pdf

REQUEST AND RELEASE OF MEDICAL INFORMATION TO COMMUNICATIONS MEDIA. For use of this form see AR 40-66; the proponent agency is the Office of The …

AUTHORIZATION FOR RELEASE OF MILITARY …

https://www.archives.gov/files/st-louis/military-personnel/public/na-13036-authorization-4-release-of-military-medical-patient-records.pdf

AUTHORIZATION FOR RELEASE OF MILITARY MEDICAL PATIENT RECORDS NOTE: Records Center personnel complete blocks #1,2,3 and 6. ... The following information is …

Veterans' Medical and Health Records | National Archives

https://www.archives.gov/veterans/military-service-records/medical-records.html

Oct 22, 2019

DD Form 877-1, 'REQUEST FOR …

https://www.esd.whs.mil/Portals/54/Documents/DD/forms/dd/dd0877-1.pdf

records must include the facility name and year of treatment. HEALTH RECORDS - NPRC maintains health records for all U.S. Coast Guard and for military personnel separated …

Request Military Service Records

https://www.archives.gov/veterans/military-service-records

No, I don't know my request number. You may also telephone the NPRC Customer Service Line (this is a long-distance call for most customers): 314-801-0800. Note: Our peak calling …

Request Military Personnel Records Using Standard …

https://www.archives.gov/veterans/military-service-records/standard-form-180.html

Mail a letter or Standard Form (SF) 180, Request Pertaining to Military Records to: National Personnel Records Center. 1 Archives Drive. St. Louis, MO 63138. …

DD Form 2870, Authorization for Disclosure of …

https://www.dover.af.mil/Portals/22/documents/units/auth_to_disclose_dd_2870.pdf?ver=2016-05-24-114510-350

Failure to sign the authorization form will result in the non-release of the protected health information. This form will not be used for the authorization to disclose …

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