Chapter 1 - FORM 1-14 : REQUEST FOR AND AUTHORIZATION TO RELEASE MEDICAL RECORDS (VA )
| Jurisdiction | Colorado |
Form 1-14: Request for and Authorization to Release Medical Records (VA Form 10-5345)
NOTES ON USE:
This form was created by the U.S. Department of Veterans Affairs, and it is available in fillable form on the Department's website at http://www.va.gov/ vaforms/medical/pdf/vha-10-5345-fill.pdf.
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Request your trial- Colorado Civil Pretrial Handbook (CBA)
- Chapter 1
- Chapter 1 - CHAPTER 1: BRINGING SUIT—PRE-FILING CONSIDERATIONS, REQUIREMENTS, AND STRATEGY
- Chapter 1 - § 1.1 PRE-SUIT CONSIDERATIONS
- Chapter 1 - § 1.2 PARTIES
- Chapter 1 - § 1.3 DEMAND LETTERS
- Chapter 1 - § 1.4 ADDITIONAL ETHICAL CONSIDERATIONS
- Chapter 1 - APPENDIX TO CHAPTER 1: FORMS
- Chapter 1 - FORM 1-1 : DISCLOSURE STATEMENT REGARDING CONTINGENCY FEES (C.R.C.P. CH 23.3, FORM 1)
- Chapter 1 - FORM 1-2 : CONTINGENT FEE AGREEMENT (C.R.C.P. CH 23.3, FORM 2)
- Chapter 1 - FORM 1-3 : FINAL DISBURSEMENT STATEMENT (C.R.C.P. CH 23.3, FORM 2)
- Chapter 1 - FORM 1-4 : FEE RETAINER AGREEMENT—WITH STANDARD TERMS OF ENGAGEMENT
- Chapter 1 - FORM 1-5 : NEW CLIENT QUESTIONNAIRE
- Chapter 1 - FORM 1-6 : AUTHORIZATION TO RELEASE EMPLOYMENT RECORDS
- Chapter 1 - FORM 1-7 : AUTHORIZATION FOR RELEASE OF EDUCATIONAL RECORDS
- Chapter 1 - FORM 1-8 : FREEDOM OF INFORMATION ACT (FOIA) REQUEST LETTER
- Chapter 1 - FORM 1-9 : CONSENT FOR RELEASE OF SOCIAL SECURITY RECORDS (SSA FORM)
- Chapter 1 - FORM 1-10 : REQUEST FOR SOCIAL SECURITY EARNINGS INFORMATION (SSA FORM)
- Chapter 1 - FORM 1-11 : REQUEST FOR COPY OF TAX RETURN (IRS FORM 4506)
- Chapter 1 - FORM 1-12 : REQUEST FOR TRANSCRIPT OF TAX RETURN (IRS FORM 4506-T)
- Chapter 1 - FORM 1-13 : AUTHORIZATION FOR RELEASE OF MEDICAL RECORDS UNDER HIPAA
- Chapter 1 - FORM 1-14 : REQUEST FOR AND AUTHORIZATION TO RELEASE MEDICAL RECORDS (VA )
- Chapter 1 - FORM 1-15 : AUTHORIZATION FOR RELEASE OF WORKERS' COMPENSATION INFORMATION
- Chapter 1 - FORM 1-16 : AUTHORIZATION FOR RELEASE OF CRIMINAL OR ARREST RECORDS
- Chapter 1 - FORM 1-17 : AUTHORIZATION TO RELEASE INSURANCE INFORMATION
- Chapter 1 - FORM 1-18 : AUTHORIZATION TO RELEASE UNION RECORDS
- Chapter 1 - FORM 1-19 : REQUEST FOR MILITARY RECORDS
- Chapter 1 - FORM 1-20 : AUTHORIZATION TO RELEASE SECURITY RECORDS
- Chapter 1 - FORM 1-21 : GENERAL FINANCIAL DISCLOSURE AUTHORIZATION
- Chapter 1 - FORM 1-22 : CLIENT LETTER—PRESERVATION OF EVIDENCE
- Chapter 1 - FORM 1-23 : PLAINTIFF'S INTRACOMPANY MEMORANDUM REGARDING PRESERVATION OF EVIDENCE
- Chapter 1 - FORM 1-24 : NOTICE OF POTENTIAL CLAIMS TO PUBLIC ENTITIES
- Chapter 1 - FORM 1-25 : NOTICE OF POTENTIAL CLAIM TO PRIMARY INSURER
- Chapter 1 - FORM 1-26 : NOTICE OF POTENTIAL CLAIM TO EXCESS OR SECONDARY COVERAGE CARRIER
- Chapter 1 - FORM 1-27 : NOTICE OF LIS PENDENS
- Chapter 1 - FORM 1-28 : CERTIFICATE OF REVIEW—OTHER PROFESSIONAL
- Chapter 1 - FORM 1-29 : COST BOND
- Chapter 1 - FORM 1-30 : NOTICE TO LANDLORD OF INTENT TO BRING SUIT
- Chapter 1 - FORM 1-31 : DEMAND LETTER
- Chapter 1 - FORM 1-32 : CEASE AND DESIST LETTER
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