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About VA Form 10-334

Form name: VA Form - Tribal Documentation Form
Related to: VHA
Form last updated: April 2028

When to use this form

Use VA Form 10-334 to request a copay exemption if you’re an eligible American Indian or Alaska Native Veteran.

Find out if you’re eligible for a VA health care copay exemption

Downloadable PDF

Download VA Form 10-334 (PDF)
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