VA Form 21-4142 and 21-4142a: Authorization to Disclose Information to the VA

Fill out VA Form 21-4142 and 21-4142a: Authorization to Disclose Information to the VA online and generate the PDF, or fill it from your own app with the DocSpring API.

About this form

Veterans use VA Forms 21-4142 and 21-4142a to let the VA request their records from private doctors and hospitals.

Healthcare Authorization

Three ways to use it

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Answer the questions on a web form, or type straight into the fields on the PDF. Switch between the two at any time.

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Send JSON to our API or one of our SDKs in 9 languages with your own API token, and get the filled PDF back. The PDFs are in your account, and we keep the form up to date.

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Try the API

Paste these commands into your terminal to generate a VA Form 21-4142 and 21-4142a: Authorization to Disclose Information to the VA PDF with a demo API token. To fill it from your own account, use one of your API tokens with its template ID, tpl_ZLrSMHC9XqMCa2NLeS. Keep sending "version": "1.0.1" so that nothing changes for you when we publish a new version.

# This template has a lot of fields, so you'll need to download and run this bash script:

curl -sfSL "https://app.docspring.com/api/v1/templates/tpl_ZLrSMHC9XqMCa2NLeS/curl_example.sh?version=1.0.1" \
  -u "api_nXerNcJM5LRThDXgka:9pAJQZb5mYQZHjQHjZCQJJ9hxSPGL9ZAYc3QFxgQCE" \
  -o "/tmp/docspring_tpl_ZLrSMHC9XqMCa2NLeS.sh"
bash "/tmp/docspring_tpl_ZLrSMHC9XqMCa2NLeS.sh"
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