Care Partner

Gloria Neumann, Chief Suicide Prevention Coordinator with the Dorn VA has shared the attached VA form with Hidden Wounds. This form is a standard release of information form. The term “care partner” is not an official one yet. It is a way to describe someone who the Veteran wants to assist them in getting care and/or planning their treatment. It is also someone who the VA can contact if they can’t reach the Veteran.

Hidden Wounds is promoting that a Veteran suffering from PTSD, TBI, depression or other issues with informed consent can sign The Care Partner HIPPA release form 10-5345 giving Hidden Wounds access to portions of their health records.

Veterans who sign this form will allow the VA to contact Hidden Wounds to coordinate care. Veterans are informed that if they sign this form, they are giving up part of their privacy. Hidden Wounds will utilize Veterans case information only on a need to know basis for coordination of care. Veterans are informed that they can exclude release of any specific information by adding a phrase such as “except information about …” in the information requested box.

Click the following link to download the Care Partner HIPPA Release form 10-5345.