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. This form is not valid to designate a representative for the Appeals process. There is a separate form in the forms list for the appeals process.
Authorization for Disclosure (DD Form 2870)
You must have the following information to complete the form properly:
- Your name, signature, and date
- The name of the person you are authorizing to receive information on your behalf
- The date that you would like the consent to expire
- Your sponsor number (the Social Security Number of the family member who served)