Electronic Request for Consent to Disclose

Once we have verified your identity, you can electronically consent to and authorize the Social Security Administration (SSA) to disclose any of the following records to another person or entity. Please click here to submit your online request.

• Verification of Social Security number
• Current monthly Social Security benefit amount
• Current monthly Supplemental Security Income payment amount
• Social Security benefit amounts
• Supplemental Security Income payment amounts
• Medicare entitlement
• Medical records from my claims folder(s)
• Application(s) for benefits
• Award notice(s)
• Denial notice(s)
• Appeal request(s)

Do NOT use this form to

• Make requests if you are not at least 18 years of age.
• Request access to information or records to be sent to yourself.
• Consent to SSA disclosing a minor child’s records to a third party.
• Consent to SSA disclosing a legally incompetent adult’s records to a third party.
• Request access to your earnings records or consent to SSA disclosing your earnings records to a third party.

If you do not want to or you are unable to submit your request electronically, please contact your local servicing office.  To locate the appropriate servicing office, visit https://secure.ssa.gov/ICON/main.jsp and input your zip code.