United States Department of Veterans Affairs

VA Pacific Islands Health Care System

Release of Information

Our Release of Information staff will be happy to assist you with requests for your medical records. We also assist providers with completing forms for patients.

We can assist you with the following —

  • access to your medical records
  • obtaining copies of your medical records
  • requests to amend your medical records
  • completion of forms for benefits, insurance, and other reasons

You may fill out a Release of Medical Information request at the Spark M. Matsunaga VA Medical Center and/or direct any questions to (808) 433-0506, (808) 433-7713, or (808) 433-0489.


Patient Information

Patient Information
Eligibility
Make, Change, or Cancel an Appointment 
Advance Directives 
Patient Education
Customer Service 
Discharge
Billing and Insurance 
Release of Information 

Release of Information Forms

pdf document Request for and Authorization to Release Medical Records or Health Information (VA 10-5345) 
pdf document Individuals' Request for a Copy of Their Own Health Information (VA 10-5345a) 

Related Links

Notice of Privacy Practices