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REQUEST FOR MEDICAL/DENTAL RECORDS FROM THE NATIONAL PERSONNEL RECORDS CENTER (NPRC) (ST. LOUIS, MISSOURI) (For Agency Use Only) See Instructions on back before completing form. REQUESTING ACTIVITY:.

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To request clinical and medical treatment records: Although not mandatory, using the NA Form 13042 is the recommended method to send a request for medical records/information. This form captures all the necessary information to locate a medical record. Please provide as much information on the form as possible.

Allow about 10 days for us to receive and process your request, then you may check the status of your request. These forms are ONLY for status updates for EXISTING requests from the National Personnel Records Center (NPRC).

DD Form 877, "REQUEST FOR MEDICAL/DENTAL RECORDS OR INFORMATION"

The NPRC is the records custodian for most discharged and retired members of all branches of service. The fastest way to obtain a copy is through their website, at http://.archives.gov/veterans/. Expect a two to three week wait to receive requested records.

Authorization for Disclosure of Medical or Dental Information (DD Form 2870) Use this form to authorize an individual to release information that is protected under the Federal Privacy Act.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232