Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Authorization to Disclose Information to the VA (VA Form 21-4142), General Release of Medical Provider Information to the VA (VA Form 21-4142a) Modified 127397 10616 0 Form VA Form 21-4142
Form VA Form 21-4142a
Total burden requested under this ICR: 127397 10616 0  
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