United States Department of Veterans Affairs
United States Department of Veterans Affairs

Tennessee Valley Healthcare System

Release of Information

Release of Information 

Our Release of Information staff will be happy to assist you with requests for your medical records. We also assist providers with completing forms for patients.

We can assist you with the following —

  • access to your medical records
  • obtaining copies of your medical records
  • requests to amend your medical records
  • completion of forms for benefits, insurance, and other reasons

The Release of Information Staff are experts in our patients' rights and their medical records.

The Release of Information Office is located in the first floor of the Nashville Campus in Room 1-E106 and Building 2, Room 15 at the Alvin C. York Campus.

How to Request Information

To request a medical record, please one of the forms listed in the column to the right, complete the requested information, sign the form, and mail it to one of the following addresses —

Nashville Campus:
VA Tennessee Valley Healthcare System
1310 24th Avenue South
Attn: Release of Information
Nashville, TN 37212-2637

Alvin C. York Campus:
VA Tennessee Valley Healthcare System
3400 Lebanon Pike
Attn: Release of Information
Murfreesboro, TN 37129

Because forms must contain an original signature, e-mailed forms cannot be accepted.  Requests for records will take approximately 10-14 days to process.

Fees

There is no cost to send copies directly to another health care provider. If copies are for a patient's personal use, photocopying fees may be assessed.


Information for Patients

Information for Patients
Eligibility
Make, Change, or Cancel an Appointment
Advance Directives
Patient Education
Customer Service
Discharge
Billing and Insurance
Release of Information

Release of Information Forms

pdf document Request for and Authorization to Release Medical Records or Health Information (VA 10-5345)
pdf document Individuals' Request for Medical Records from MyHealtheVet (VA 10-5345a-MHV)
pdf document Individuals' Request for a Copy of Their Own Health Information (VA 10-5345a)

Related Links

Notice of Privacy Practices