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Written Consent To Release Medical Records Protected_by 38 U.s.c. 7332 -- 38 Cfr 1.475(a)

IC 148397 under ICR 199307-2900-012 · OMB 2900-0544.

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WRITTEN CONSENT TO RELEASE MEDICAL RECORDS PROTECTED_BY 38 U.S.C. 7332 -- 38 CFR 1.475(A)
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability


    

20,640 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1 0 1 0 0 0
Annual IC Time Burden (Hours) 1,720 0 1,720 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
 
 
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.