VA Form 10-10164: Opt Out of VA Health Info Sharing

VA Form 10-10164: OPT Out of VA Health Info Sharing – If you are a veteran who receives care through the U.S. Department of Veterans Affairs (VA) and want to limit the electronic sharing of your protected health information, VA Form 10-10164 is the official document you need. This form allows you to opt out of the Veterans Health Information Exchange (VHIE) for treatment purposes. VA automatically includes eligible veterans in electronic health information sharing with participating non-VA providers, but you have the right to opt out at any time.

This comprehensive guide explains everything you need to know about VA Form 10-10164, including its purpose, how to complete it, submission options (including a convenient online method through My HealtheVet), what happens when you opt out, and trusted official resources. All information is based on current VA policies and forms as of 2026.

What Is VA Form 10-10164?

VA Form 10-10164, titled “Opt-Out of Sharing Protected Health Information Through Health Information Exchanges,” is the official VA form used by veterans to request that their protected health information (PHI) no longer be shared electronically through health information exchanges for treatment purposes.

The form was last revised in April 2020. By signing it, you direct the VA to stop electronic sharing of your health records with participating non-VA healthcare providers and partners via the Veterans Health Information Exchange (VHIE), except in life-threatening medical emergencies.

Download the official form here:
Download VA Form 10-10164 (PDF)

Understanding VA’s Electronic Health Information Sharing (VHIE)

The Veterans Health Information Exchange (VHIE) is VA’s secure system that allows electronic sharing of veterans’ health information with participating non-VA providers and federal partners (such as the Department of Defense) when they are treating you. This is part of broader efforts under the MISSION Act to improve care coordination between VA and community providers.

Shared information typically includes:

  • Medications and prescriptions
  • Allergies
  • Lab and radiology results (excluding most images)
  • Immunizations
  • Clinical notes and procedures
  • Other relevant medical history

Sharing happens only with participating providers who are treating you and occurs through a secure gateway. By default, veterans are included in this electronic sharing unless they opt out.

Learn more:
Veterans Health Information Exchange (VHIE) – Official VA Page
About Electronic Health Information Sharing at VA

Benefits of Health Information Exchange for Veterans

When electronic sharing is active, participating community providers treating you can access your VA records quickly. This helps:

  • Provide a more complete picture of your health history
  • Reduce duplicate tests and procedures
  • Improve medication safety and coordination
  • Eliminate the need to carry paper records or wait for faxes
  • Support faster, safer treatment decisions

Many veterans appreciate this seamless coordination, especially when receiving care from both VA and non-VA providers.

Why Veterans Choose to Opt Out with VA Form 10-10164?

While most veterans benefit from electronic sharing, some prefer to limit it for personal privacy reasons. Common reasons include:

  • Strong preference for controlling exactly who sees their records
  • Concerns about data security or past experiences with information sharing
  • Desire to manage records through paper, fax, or direct requests only
  • Specific family or legal situations

Opting out is completely voluntary and does not affect your eligibility for VA benefits or access to care from any provider.

What Happens When You Opt Out of VA Health Information Sharing?

When you successfully opt out using VA Form 10-10164 (or the online My HealtheVet tool):

  • VA will stop sharing your health information electronically through HIE/VHIE for routine treatment purposes.
  • Your information can still be shared via paper records, fax, or other legally permitted methods when needed.
  • In a life-threatening medical emergency, VA may still share necessary information.
  • Participating non-VA providers will not receive your VA records electronically before or during treatment.
  • Your access to VA healthcare and community care remains unchanged.

Important: If you previously submitted an older opt-out form (VA Form 10-0484) before September 30, 2019, your opt-out status remains in effect. You do not need to submit Form 10-10164 unless you want to confirm or change your preference.

How to Opt Out of VA Health Information Sharing?

VA offers multiple convenient ways to opt out. The easiest method for most veterans is through the online My HealtheVet portal.

Option 1: Online via My HealtheVet (Recommended)

  1. Sign in to your account at My HealtheVet on VA.gov.
  2. Go to the Medical Records section.
  3. Select “Go to manage your electronic share settings”.
  4. Choose the option to Opt out.

This updates your preferences immediately in most cases and serves as the electronic equivalent of submitting VA Form 10-10164.

Option 2: Paper Form (VA Form 10-10164)

Complete the official form and submit it using one of the methods below.

Step-by-Step Instructions to Complete VA Form 10-10164

The form is straightforward and only requires basic information plus your signature.

  1. Print your full name — Last name, first name, and middle name (if applicable).
  2. Enter your 9-digit Social Security Number (SSN) — This is required so VA can locate your records. Providing an incomplete or inaccurate SSN will prevent VA from processing your opt-out request.
  3. Read the certification statement carefully. By signing, you confirm that you understand VA will stop electronic HIE sharing for treatment (except life-threatening emergencies) and that your decision is voluntary.
  4. Sign and date the form — Sign in ink and enter today’s date (MM/DD/YYYY). A legal representative (such as a health care power of attorney or guardian) may sign on your behalf if they attach proof of authority.

Key statement on the form (verbatim summary): By signing, you direct VA to opt you out of electronic sharing through HIE partners. Your information will continue to be shared by paper, fax, or other legal means. This decision remains in effect until you cancel it in writing using VA Form 10-10163.

Download the fillable PDF:
VA Form 10-10164 Official Fillable PDF

Where and How to Submit Your Completed VA Form 10-10164?

Submit the signed form to your local VA facility’s Release of Information (ROI) office using one of these methods:

  • In Person: Take the completed form to the ROI office at your nearest VA medical center or clinic.
  • By Mail: Mail the form to the ROI office at your nearest VA facility.

Find your nearest VA facility and ROI contact information:
VA Facility Locator Tool

After submission, processing times vary. You can check your status by contacting the ROI office or logging into My HealtheVet.

How to Check Your Current Sharing Status or Opt Back In?

You can review or change your electronic sharing preferences anytime:

To resume electronic sharing later, use VA Form 10-10163 (Request for and Permission to Participate in Sharing Protected Health Information Through Health Information Exchanges) or the online My HealtheVet tool.

Download the opt-in form:
Download VA Form 10-10163 (PDF)

Frequently Asked Questions About VA Form 10-10164

Does opting out affect my VA healthcare or benefits?

No. Opting out does not impact your access to VA care, community care, or any benefits.

Can I still get my records if I opt out?

Yes. You can request your VA medical records directly through My HealtheVet, the ROI office, or by submitting a records request. Non-VA providers can still obtain records via paper or fax when needed.

Is my information still secure if I opt out?

Yes. All VA health information remains protected under federal privacy laws, including the Privacy Act and HIPAA-equivalent protections. Opting out simply stops automatic electronic exchange through HIE.

Can active duty service members opt out?

According to the form instructions, active duty service members may not be permitted to opt out due to Department of Defense policies.

How long does the opt-out last?

It remains in effect until you cancel it in writing using VA Form 10-10163 or the online My HealtheVet tool.

Additional Resources for Veterans Managing Health Records

Here are trusted, official resources to help you manage your VA health information and privacy preferences:

Final Tips for Veterans

  • Check your current sharing status in My HealtheVet before deciding.
  • Keep a copy of your submitted form and confirmation for your records.
  • Contact your local ROI office or the VHIE helpline if you have questions about processing.
  • Review VA’s Notice of Privacy Practices for full details on how your information is protected.