Healthcare Forms
Browse official and fillable healthcare PDFs. Open a form to fill it online, download a blank copy, or print it for filing.
Find the right healthcare form
Healthcare forms are commonly used by patients, clinics, benefits teams, caregivers, and medical administrators. This hub organizes 343 fillable PDFs so you can find the right document, fill it online, download a blank copy, and keep a record for filing.
Filing checklist
- Open the form detail page and verify the agency, year, revision date, and source link.
- Read the official instructions before submitting the completed form.
- Confirm the current form and submission method with the provider, insurer, or benefits office.
- Review privacy requirements before sharing completed medical or insurance paperwork.
343 Healthcare Forms
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VA Form 10-10116C(2016)
Health Care For Homeless Veterans (HCHV) Contracted Residential Services (CRS) Action Sheet
Official Department of Veterans Affairs 10-10116C for Health Care For Homeless Veterans (HCHV) Contracted Residential Services (CRS) Action Sheet, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-10118(2014)
Designee for Patient Personal Property
Official Department of Veterans Affairs 10-10118 for Designee for Patient Personal Property, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-10145(2016)
Veterans Health Administration (VHA) Veterans Choice Program Provider Agreement
Official Department of Veterans Affairs 10-10145 for Veterans Health Administration (VHA) Veterans Choice Program Provider Agreement, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-10152(2023)
Reimbursement Request for Qualifying Adoption Expenses
Official Department of Veterans Affairs 10-10152 for Reimbursement Request for Qualifying Adoption Expenses, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-10163(2021)
Request for and Permission to Participate in Sharing Protected Health Information through Health Information Exchanges
Official Department of Veterans Affairs 10-10163 for Request for and Permission to Participate in Sharing Protected Health Information through Health Information Exchanges, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-10164(2020)
Opt-Out of Sharing Protected Health Information Through Health Information Exchanges
Official Department of Veterans Affairs 10-10164 for Opt-Out of Sharing Protected Health Information Through Health Information Exchanges, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-10171(2019)
Veterans Health Administration (VHA) Veterans Care Agreement
Official Department of Veterans Affairs 10-10171 for Veterans Health Administration (VHA) Veterans Care Agreement, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-10CG(2024)
Application for Comprehensive Assistance for Family Caregivers Program
Use VA Form 10-10CG to apply for the Program of Comprehensive Assistance for Family Caregivers. Each time a new caregiver is appointed, a new VA Form 10-10CG is required.
VA Form 10-10D(2025)
Application for CHAMPVA Benefits
If you're the spouse or child of a Veteran with disabilities, or the surviving spouse or child of a Veteran who has died, use VA Form 10-10d to apply for health insurance through CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs).
VA Form 10-10EZ-S(2025)
Application For Health Benefits- Spanish
Official Department of Veterans Affairs 10-10EZ-S for Application For Health Benefits- Spanish, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-10EZR(2025)
Health Benefits Update Form
Use VA Form 10-10EZR if you already receive VA health care benefits, and you need to update your personal, insurance, financial, or military service history information.
VA Form 10-10EZR-S(2025)
Health Benefits Update Form- Spanish
Official Department of Veterans Affairs 10-10EZR-S for Health Benefits Update Form- Spanish, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-10M(2016)
Medical Certificate
Official Department of Veterans Affairs 10-10M for Medical Certificate, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-10SH(2021)
State Home Program Application for Veteran Care Medical Certification
Official Department of Veterans Affairs 10-10SH for State Home Program Application for Veteran Care Medical Certification, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-1314(2002)
Health Services Research and Development Service Career Development Awardee-Annual Progress Report
Official Department of Veterans Affairs 10-1314 for Health Services Research and Development Service Career Development Awardee-Annual Progress Report, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-1388(1989)
Medical Media Production Service Daybook
Official Department of Veterans Affairs 10-1388 for Medical Media Production Service Daybook, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2382(1999)
Certification of Inpatient/Outpatient Visit
Official Department of Veterans Affairs 10-2382 for Certification of Inpatient/Outpatient Visit, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2406(2003)
Recommendation for Release of Patient in Home Other Than Patient's Own
Official Department of Veterans Affairs 10-2406 for Recommendation for Release of Patient in Home Other Than Patient's Own, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2409(1997)
Patient's Agreement with Hospital in Relation to Home Other Than His Own
Official Department of Veterans Affairs 10-2409 for Patient's Agreement with Hospital in Relation to Home Other Than His Own, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2410(1997)
Agreement to Provide Home Care for Patient
Official Department of Veterans Affairs 10-2410 for Agreement to Provide Home Care for Patient, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2421(2007)
Prosthetic Authorization for Items or Services
Official Department of Veterans Affairs 10-2421 for Prosthetic Authorization for Items or Services, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2431(2008)
Request for Prosthetic Services - fillable
Official Department of Veterans Affairs 10-2431 for Request for Prosthetic Services - fillable, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2478(2006)
Veterans Request for Refill of Medications and/or Medical Supplies
Official Department of Veterans Affairs 10-2478 for Veterans Request for Refill of Medications and/or Medical Supplies, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-2501(2009)
Prosthetic Service Card
Official Department of Veterans Affairs 10-2501 for Prosthetic Service Card, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
Common mistakes to avoid
- Missing patient identifiers, policy numbers, dates of service, or provider details.
- Sending protected health information to the wrong recipient.
- Forgetting consent, release, signature, or representative authorization fields.