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Search our library of federal VA and DoD forms. Download official PDFs straight from the government source, or follow the link to the official site -- no third-party copies, no outdated versions.

9 results in Healthcare

VA Form 10-10EZ

Application for Health Benefits

The primary application to enroll in VA healthcare. Covers eligibility determination, priority group assignment, and copay assessment.

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VA Form 10-10EZR

Health Benefits Renewal/Update

Update your personal, insurance, or financial information for VA healthcare. Use this form annually or when your situation changes.

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VA Form 10-7959a

CHAMPVA Application

Apply for the Civilian Health and Medical Program of the VA (CHAMPVA). Available to spouses and children of veterans with permanent and total service-connected disabilities.

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VA Form 10-7959c

CHAMPVA Other Health Insurance Certification

Report other health insurance information if you are enrolled in CHAMPVA. Required to coordinate benefits with other coverage.

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VA Form 10-5345

Request for and Authorization to Release Medical Records

Authorize the release of your VA medical records to yourself, another provider, or a third party. Also used to request copies of your VA health records.

HealthcareVA
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VA Form 10-3542

Veteran/Beneficiary Claim for Reimbursement of Travel Expenses

Claim reimbursement for travel to and from VA medical appointments. Covers mileage, tolls, and parking for eligible veterans.

HealthcareVA
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VA Form 10-7959f-1

Foreign Medical Program (FMP) Claim

Submit claims for healthcare received outside the United States if you have a service-connected condition. Available to veterans living or traveling abroad who are enrolled in the Foreign Medical Program.

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Blue Button ReportDocument

VA Blue Button Health Report

A downloadable report of your complete VA health records including medications, allergies, lab results, and clinical notes. Access through My HealtheVet or the VA Health and Benefits app.

HealthcareVA
Community Care AuthorizationDocument

VA Community Care Referral Authorization

Authorization document from the VA allowing you to receive care from a community (non-VA) provider. Issued when the VA cannot provide timely care or when you meet eligibility criteria under the MISSION Act.

HealthcareVA