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Form to submit questions about clinical decisions and treatments

Form name:Clinical Determinations and Indications Question Submission Form (VA Form 10-322)
Form revision date: February 2024
Related to: Health care

When to use this form

Use VA form 10-322 if you’re a VA health care or community provider and you want to submit a question about VA Community Care Clinical Determinations and Indications (CDIs). This includes questions about whether a specific service or treatment meets clinical criteria.

Downloadable PDF

Helpful links related to VA Form 10-322

  • Our VA community care network helps us offer Veterans quality health care outside VA, in their local communities, when needed. Learn about our network and covered services. And get answers to common questions about community care.

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