Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Authorization to Disclose Information to the VA, General Release of Medical Provider Information to the VA (VA Forms 21-4142 and 21-4142a) New 132400 11033 0 Form 21-4142
Form 21-4142a
Total burden requested under this ICR: 132400 11033 0  
To view an IC, click on IC Title