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To find a form, enter the form number (example: 12-1234 or 1234) or a word from the form's title or subject.
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Number Title Issue Date Revision Date # Pages
20-0968 Claim for Reimbursement of Travel Expenses (Fillable) 04/09/2015 03/2015 3
20-572 Request for Change of Address/Cancellation of Direct Deposit (Fillable) 06/04/2010 03/1996 1
20-8206 VA Statement of Assurance of Compliance with Equal Opportunity Laws 01/09/2015 05/2006 1
20-8800 Request for VA Forms and Publications (Fillable) 06/04/2010 01/2001 1
21-0304 Application for Benefits for Certain Children with Disabilities Born of Vietnam and Certain Korea Service Veterans (Fillable) 06/22/2016 06/2016 3
21-0307 Award Attachment for Certain Children with Disabilities Born of Vietnam Veterans 01/13/2015 03/2004 2
21-0506 Due Process Rights (No Fill-in) 06/12/2015 04/2012 1
21-0760 VA Benefits in Brief (No Fill-in) 03/24/2016 08/2009 2
21-0779 Req. for Nursing Home Info. in Connect. with Claim for Aid and Attendance (Fill) 06/12/2015 03/2010 1
21-0781 Statement in Support of Claim for Service Connection for PTSD (Fillable) 06/10/2015 8/2014 2
21-0781a Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder (PTSD) Secondary to Personal Assault (Fillable) 05/06/2015 8/2014 3
21-0788 Information Regarding Apportionment of Beneficiary's Award (Fillable) 07/19/2016 11/2014 2
21-0790 Your Rights to Representation and a Hearing (Possible Overpayment) (No Fill-in) 01/09/2015 02/2005 2
21-0819 VA/DOD Joint Disability Evaluation Board Claim (Fillable) 07/25/2016 07/2016 2
21-0845 Authorization To Disclose Personal Information To a Third Party (Fillable) 05/22/2015 05/2015 2
21-0958 Notice of Disagreement (Fillable) 02/23/2016 9/2015 4
21-0960A-1 Ischemic Heart Disease (IHD) Disability Benefits Questionnaire (Fillable) 05/05/2014 01/2014 2
21-0960A-2 Artery and Vein Conditions (Vascular Diseases Including Varicose Veins) Disability Benefits Questionnaire (Fillable) 07/13/2016 12/2014 5
21-0960A-3 Hypertension Disability Benefits Questionnaire (Fillable) 07/12/2016 12/2014 2
21-0960A-4 Heart Conditions (Including Ischemic and Non-Ischemic Heart Disease, Arrhythmias, Valvular Disease and Cardiac Surgery) Disability Benefits Questionnaire (Fillable) 07/18/2016 12/2014 7
21-0960B-1 Hairy Cell and Other B-Cell Leukemias Disability Benefits Questionnaire (Fillable) 01/23/2015 01/2014 2
21-0960B-2 Hematologic and Lymphatic Conditions, Including Leukemia Disability Benefits Questionnaire (Fillable) 08/24/2016 02/2015 4
21-0960C-1 Parkinson's Disease Disability Benefits Questionnaire (Fillable) 01/09/2015 01/2014 2
21-0960C-10 Peripheral Nerves Conditions (Not Including Diabetic Sensory - Motor Peripheral Neuropathy) Disability Benefits Questionnaire (Fillable) 08/24/2016 02/2015 8
21-0960C-11 Seizure Disorders (Epilepsy) Disability Benefits Questionnaire (Fillable) 08/05/2015 10/2012 4
21-0960C-2 Amotrophic Lateral Sclerosis (Lou Gehrig's Disease) Disability Benefits Questionnaire (Fillable) 08/24/2016 02/2015 7
21-0960C-3 Cranial Nerve Conditions Disability Benefits Questionnaire (Fillable) 08/05/2015 10/2012 5
21-0960C-4 Diabetic Sensory-Motor Peripheral Neuropathy Disability Benefits Questionnaire (Fillable) 07/14/2016 12/2014 5
21-0960C-5 Central Nervous System and Neuromuscular Diseases (Except Trau. Brain Injury, etc.) Disability Benefits Questionnaire (Fillable) 08/05/2015 10/2012 9
21-0960C-6 Narcolepsy Disability Benefits Questionnaire (Fillable) 08/05/2015 10/2012 2
21-0960C-7 Fibromyalgia Disability Benefits Questionnaire (Fillable) 05/07/2013 10/2012 3
21-0960C-8 Headaches (Including Migraine Headaches) Disability Benefits Questionnaire (Fillable) 08/05/2015 10/2012 3
21-0960C-9 Multiple Sclerosis (MS) Disability Benefits Questionnaire (Fillable) 09/02/2015 10/2012 9
21-0960D-1 Oral and Dental Conditions Including Mouth, Lips and Tongue (Other Than Temporomandibular Joint Conditions) Disability Benefits Questionnaire (Fillable) 05/07/2013 10/2012 5
21-0960E-1 Diabetes Mellitus Disability Benefits Questionnaire (Fillable) 07/13/2016 12/2014 3
21-0960E-2 Endocrine Diseases (Other than Thyroid, Parathyroid or Diabetes Mellitus) Disability Benefits Questionnaire (Fillable) 08/05/2015 10/2012 4
21-0960E-3 Thyroid and Parathyroid Conditions Disability Benefits Questionnaire (Fillable) 08/05/2015 10/2012 6
21-0960F-1 Scars/Disfigurement Disability Benefits Questionnaire (Fillable) 07/26/2016 12/2014 7
21-0960F-2 Skin Diseases Disability Benefits Questionnaire (Fillable) 07/14/2016 12/2014 5
21-0960G-1 Esophageal Conditions (Including gastroesophageal reflux disease (GERD), hiatal hernia and other esophageal disorders) Disability Benefits Questionnaire (Fillable) 05/02/2013 10/2012 4
21-0960G-2 Gallbladder and Pancreas Conditions Disability Benefits Questionnaire (Fillable) 08/07/2015 10/2012 4
21-0960G-3 Intestinal Conditions (Other than Surgical or Infectious) (Including Irritable Bowel Syndrome, Crohn's Disease, Ulcerative Colitis, and Diverticulitis) Disability Benefits Questionnaire (Fillable) 09/02/2015 10/2012 4
21-0960G-4 Intestinal Surgery (Bowel Resection, Colostomy, Ileostomy) Disability Benefits Questionnaire (Fillable) 09/02/2015 10/2012 3
21-0960G-5 Hepatitis, Cirrhosis and Other Liver Conditions Disability Benefits Questionnaire (Fillable) 09/02/2015 10/2012 5
21-0960G-6 Peritoneal Adhesions Disability Benefits Questionnaire (Fillable) 05/02/2013 10/2012 2
21-0960G-7 Stomach and Duodenal Conditions (Not Including Gerd or Esophageal Disorders) Disability Benefits Questionnaire (Fillable) 09/02/2015 10/2012 5
21-0960G-8 Infectious Intestinal Disorders, Including Bacterial and Parasitic Infections Disability Benefits Questionnaire (Fillable) 09/02/2015 10/2012 3
21-0960H-1 Hernias (Including Abdominal, Inguinal and Femoral Hernias) Disability Benefits Questionnaire (Fillable) 09/02/2015 10/2012 3
21-0960H-2 Rectum and Anus Conditions (Including Hemorrhoids) Disability Benefits Questionnaire (Fillable) 08/07/2015 10/2012 3
21-0960I-1 Persian Gulf and Afghanistan Infectious Diseases Disability Benefits Questionnaire (Fillable) 08/24/2016 02/2015 2
 
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