PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Authorization to Disclose Information to VA (VA Form 21-4142), General Release of Medical Provider Information to VA (VA Form 21-4142a)
Modified
440246
36687
0
Form
21-4142
Authorization to Disclose Information to VA
Form
21-4142a
General Release of Medical Provider Information to VA
Total burden requested under this ICR:
440246
36687
0
To view an IC, click on IC Title
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