Veterans Crisis Line Badge
 

VA Forms

Search VA Forms

Welcome to the Department of Veterans Affairs Forms web site.

Forms on this site are available in several formats. Fillable pdf can be filled on-line, printed, saved and edited. XFT forms can be filled on-line, printed, and saved to your pc but cannot be edited later (TURN OFF YOUR POP-UP BLOCKER TO USE XFT). Some PDF are printable blank forms.

You can download viewer software at https://www.va.gov/viewer.htm
To find a form, enter the form number (example: 12-1234 or 1234) or a word from the form's title or subject.
Form Search Tips   |   Where to send forms
Sort By:
Page >> 1  2  3  4  5  6  7  8  9  10  11 
Number Title Issue Date Revision Date # Pages
10-0460 Request for Prescription Drugs from an Eligible Veteran in a State Home 02/28/2009 02/2008 3
10-0462 Political Activities Fact Sheet and Certification 05/05/2008 8/2015 1
10-0474 Application for Biospecimen Storage at a For-Profit Institution 08/10/2009 1/2011 4
10-0484 Revocation for Release of Individually-Identifiable Health Information- Fillable 01/31/2011 12/2013 1
10-0485 Request for and Authorization to Release Protected Health Information to eHealth Exchange 10/02/2012 12/2016 1
10-0491 Academic Verification - Health Professional Scholarship Program (HPSP) & Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP) 12/01/2013 01/2018 5
10-0491A Addendum to Application for Health Professional Scholarship Program (HPSP) & Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP) 12/01/2013 01/2018 1
10-0491C Annual VA Employment or Deferment Verification - Health Professional Scholarship Program (HPSP) & Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP) 12/01/2013 01/2018 1
10-0491D Education Program Completion Notice/Service Obligation Placement - HPSP $ VIOMPSP 12/01/2013 01/2018 1
10-0491E Evaluation & Recommendation Form - Health Professional Scholarship Program (HPSP) & Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP) 12/01/2013 01/2018 1
10-0491F HEALTH PROFESSIONAL SCHOLARSHIP PROGRAM (HPSP) AGREEMENT 12/01/2013 01/2018 2
10-0491G APPLICATION Health Professional Scholarship Program (HPSP) & Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP) 12/01/2013 01/2018 7
10-0491H Notice of Approaching Graduation - Health Professional Scholarship Program (HPSP) & Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP) 12/01/2013 01/2018 1
10-0491I Notice of Change and/or Annual Academic Status - Health Professional Scholarship Program (HPSP) & Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP) 12/01/2013 01/2018 1
10-0491J Request for Deferment for Advanced Education - Health Professional Scholarship Program (HPSP) & Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP) 12/01/2013 01/2018 1
10-0491K VA Scholarship Offer Response - Health Professional Scholarship Program (HPSP) & Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP) 12/01/2013 01/2018 1
10-0491L VA VISUAL IMPAIRMENT AND ORIENTATION AND MOBILITY PROFESSIONALS SCHOLARSHIP PROGRAM (VIOMPSP) AGREEMENT 12/01/2013 01/2018 2
10-0525 RESTRICTION OF THE RELEASE OF INDIVIDUALLY-IDENTIFIABLE HEALTH INFORMATION THROUGH eHEALTH EXCHANGE 02/01/2014 02/2014 1
10-0525a RESTRICTION OF THE RELEASE OF INDIVIDUALLY-IDENTIFIABLE HEALTH INFORMATION THROUGH eHEALTH EXCHANGE 06/01/2013 06/2013 2
10-0527 Request and Authorization to Release Protected Health Information to the Choice Program 02/01/2015 10/2015 1
10-0998 Your Rights To Seek Further Review Of Our HealthCare Benefits Decision 03/13/2019 2
10-10-493 TRICARE Affirmation 06/01/2013 4/2016 1
10-10-493a TRICARE For Life Affirmation 06/01/2013 4/2016 1
10-10065 Ethics Consultation Feedback Tool 02/01/2010 05/2016 1
10-10072 Supportive Services for Veteran Families (SSVF) Program APPLICATION FOR SUPPORTIVE SERVICES GRANT 01/15/2014 08/2013 10
10-10072A Supportive Services for Veteran Families (SSVF) Program Participant Satisfaction Survey 01/15/2014 04/2011 3
10-10072B Supportive Services for Veteran Families (SSVF) Program QUARTERLY GRANTEE PERFORMANCE REPORT 01/15/2014 08/2015 3
10-10072C Supportive Services for Veteran Families (SSVF) Program RENEWAL APPLICATION FOR SUPPORTIVE SERVICES GRANT 01/15/2014 08/2012 14
10-10118 Designee for Patient Personal Property 12/02/2014 02/2015 1
10-10145 DEPARTMENT OF VETERANS AFFAIRS VETERANS HEALTH ADMINISTRATION (VHA) VETERANS CHOICE PROGRAM PROVIDER AGREEMENT 12/10/2015 2/2016 6
10-10147a Request for and Authorization to Release Protected Health Information to a VA Healthcare Proxy 01/01/2016 01/2016 1
10-10147b Revocation of my VA Healthcare Proxy's Electronic Access to My Protected Health Information (PHI) in the My HealtheVet Portal 01/01/2016 01/2016 1
10-10152 Reimbursement Request for Qualifying Adoption Expenses 03/05/2018 04/2018 5
10-10154 Empoyee Incentive Scholarship Program Mobility Agreement 01/26/2018 01/2018 1
10-1023 Information Regarding Possible Claim Against Third Party fillable Stock #F01399 04/02/2004 2
10-1086 Research Consent Form - fillable 03/04/1999 8/2015 1
10-10CG Instructions for Completing Application for Comprehensive Assistance for Family Caregivers Program 05/01/2011 04/2016 4
10-10d Application for CHAMPVA Benefits- Fillable 09/17/2004 07/2014 3
10-10EC Application For Extended Care Services 04/12/2019 07/2014 5
10-10EZ Instrucciones Para Solicitar La Afiliacion A Los Beneficios Medicos 07/13/2018 7/2018 3
10-10EZ Instructions For Completing Enrollment Application For Health Benefits Online Application 08/06/2004 03/2015 1
10-10EZ (pdf) Instructions For Completing Enrollment Application For Health Benefits 07/10/2016 08/2017 4
10-10EZR Health Benefits Renewal Form (Fillable) 11/01/2004 08/2017 4
10-10HS Request for Hardship Determination 10/01/2008 03/2015 2
10-10M Medical Certificate 06/05/2003 12/2016 3
10-10SH State Home Program Application For Veteran Care Medical Certification 06/01/2016 09/2016 5
10-1170 Application for Furnishing Nursing Home Care to Beneficiaries of VA- fillable 09/15/2004 07/2007 1
10-1223 Report of Subcommittee on Human Studies (FILLABLE) 10/29/2004 12/2005 1
10-1245C VA/Department of Defense Sharing Agreement (FILLABLE) 12/29/2004 04/2011 2
10-1313-1 Merit Review Application - fillable 04/22/1999 12/2006 1
 
Page >> 1  2  3  4  5  6  7  8  9  10  11 

If you are unable to find your form here, you may want to visit:

Please send your comments or questions to

return to top go