Release of Information

Release of Information

AUTHORIZATION FOR RELEASE OF INFORMATION

In accordance with applicable law, you hereby authorize VetVantage and its designated representatives to request, obtain, and review my DD214 and associated medical records for the sole purpose of assisting with and/or evaluating my VA disability claim.

1. Scope of Authorization

This authorization specifically includes:

  • All Medical records directly related to my service-connected conditions including, but not limited to, the complete medical record, laboratory reports, imaging reports, treatment plans, etc.

  • Any Military service documents, including my DD214 and related records, that are associated with my VA disability claim.

  • Correspondence with the VA pertaining to my disability claim.

2. Terms of Authorization

You acknowledge and agree that:

  • Voluntary Authorization: This authorization is voluntary, and you may revoke it at any time by submitting a written request to VetVantage.

  • Limited Use: My personal information will be used exclusively for assisting with and/or evaluating my VA disability claim and will not be shared with third parties or otherwise redisclosed without my written consent, except as required by law (e.g., 45 C.F.R. Part 164).

  • No Impact on VA Benefits: Refusing to sign this authorization will not affect my VA benefits eligibility, but it may limit VetVantage ability to evaluate my eligibility and/or provide assistance.

  • Confidentiality & Security: VetVantage agrees to handle my personal data in compliance with all applicable laws and take reasonable precautions to prevent unauthorized disclosure.

  • Limited Liability & Indemnification: You understand that VetVantage and its employees, agents, or representatives assume no liability for any claims, disputes, or damages that may arise from the retrieval, use, or review of my records. You agree to indemnify and hold VetVantage harmless from any legal claims arising from the authorized use of my information.

  • Duration of Authorization: This authorization will remain in effect for one (1) year from the date of signature, unless revoked in writing before that time.

Driving Growth, Amplifying Impact

George Owens

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Kim Wexler

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James Cart

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Empowering Veterans

Championing the rights of Veterans by providing them with access to a dedicated private doctor network for their VA disability benefits.

Not Endorsed by the Department of Veterans Affairs or Department of Defense

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