Official Healthcare Forms
Official-source healthcare, Medicare, benefits, authorization, claim, provider, and patient forms from government agencies.
Use current official-source forms
These pages prioritize forms with government or issuing-authority sources, source links, PDF workflows, and clear filing context. Always confirm final filing rules, fees, and submission channels with the official source.
Before filing
- Confirm the health program, beneficiary, provider, authorization, or claim context.
- Check privacy, identity, medical evidence, and signature requirements before submission.
- Use the issuing agency source page for current filing instructions and supporting documents.
342 Healthcare Forms
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VA Form 10-7078(2005)
Authorization and Invoice for Medical and Hospital Services
Official Department of Veterans Affairs 10-7078 for Authorization and Invoice for Medical and Hospital Services, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-7959A(2025)
CHAMPVA Claim Form
If you're currently enrolled in the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), use form 10-7959A to file a claim for reimbursement. Only use VA Form 10-7959A if you've already received your CHAMPVA enrollment packet in the mail.
VA Form 10-7959C(2025)
CHAMPVA-Other Health Insurance (OHI) Certification
Only use VA Form 10-7959C or Formulario VA 10-7959c (espanol) if one of these descriptions is true for you: You're applying for CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs), and have other health insurance to declare as part of your VA Form 10-10d application, or You're already...
VA Form 10-7959D(2021)
CHAMPVA Potential Liability Claim
Official Department of Veterans Affairs 10-7959D for CHAMPVA Potential Liability Claim, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-7959F-2(2025)
Foreign Medical Program (FMP) Claim Cover Sheet
Official Department of Veterans Affairs 10-7959F-2 for Foreign Medical Program (FMP) Claim Cover Sheet, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-7976D(1990)
Medical Staff Worksheet
Official Department of Veterans Affairs 10-7976D for Medical Staff Worksheet, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-8001(2015)
Refusal to Transfer to VA Health Care Facility
Official Department of Veterans Affairs 10-8001 for Refusal to Transfer to VA Health Care Facility, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-8678(2023)
Application for Annual Clothing Allowance
Official Department of Veterans Affairs 10-8678 for Application for Annual Clothing Allowance, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-9034B(1993)
Medical Record Report (cut sheet)
Official Department of Veterans Affairs 10-9034B for Medical Record Report (cut sheet), sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-9050(2020)
Health Care Personnel Influenza Vaccination Form
Official Department of Veterans Affairs 10-9050 for Health Care Personnel Influenza Vaccination Form, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-9051(2018)
Privacy Act Statement for Environmental Health Registry Examinations
Official Department of Veterans Affairs 10-9051 for Privacy Act Statement for Environmental Health Registry Examinations, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-9054(2018)
Medical Education Affiliation Agreement Between VA and Institutions with Undergraduate Medical Education (UME)
Official Department of Veterans Affairs 10-9054 for Medical Education Affiliation Agreement Between VA and Institutions with Undergraduate Medical Education (UME), sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-9055(2018)
Graduate Medical Education Affiliation Agreement between VA and Institutions Sponsoring Graduate Medical Education
Official Department of Veterans Affairs 10-9055 for Graduate Medical Education Affiliation Agreement between VA and Institutions Sponsoring Graduate Medical Education, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 21-0781(2024)
Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s)
Use VA Form 21-0781 if you've been diagnosed with a mental health condition related to a traumatic event during your military service, and you want to apply for related benefits or services. As of June 28, 2024, we've discontinued a similar form, Statement in Support of Claim for Service Connection for PTSD Secondary...
VA Form 21-0845(2023)
Authorization to Disclose Personal Information to a Third Party
Use VA Form 21-0845 to authorize VA to share your personal information with a non-VA (third-party) individual or organization.
VA Form 21-22A(2023)
Appointment of Individual As Claimant's Representative
If you want to have an individual help you with your claim or benefits, have that person complete and submit this form.
VA Form 21-4138(2024)
Statement in Support of Claim
Use VA Form 21-4138 to provide additional information to support your claim.
VA Form 21-4142A(2024)
General Release for Medical Provider Information to the Department of Veterans Affairs
Use VA Form 21-4142a to give us permission to get medical provider information from a non-VA source like a private doctor or hospital. This will allow us to gather information like the name and address of a facility and your medical treatment dates.
VA Form 21P-8416(2023)
Medical Expense Report
Use VA Form 21P-8416 to report medical or dental expenses that you have paid for yourself or for a family member living in your household. These must be expenses you weren't reimbursed for and don't expect to be reimbursed for.
VA Form 21P-8416B(2024)
Report of Medical, Legal, and Other Expenses Incident to Recovery for Injury or Death
Official Department of Veterans Affairs 21P-8416B for Report of Medical, Legal, and Other Expenses Incident to Recovery for Injury or Death, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 22-10282(2023)
IBM Skillsbuild Training Program Intake Application
Use VA Form 22-10282 to apply for the IBM SkillsBuild program. This program provides free online services to help you start or advance your career in technology.
VA Form 29-0152(2024)
Application for Conversion Government Life Insurance
Official Department of Veterans Affairs 29-0152 for Application for Conversion Government Life Insurance, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 29-0165(2026)
VA Matic Enrollment/Change
Official Department of Veterans Affairs 29-0165 for VA Matic Enrollment/Change, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 29-0309(2024)
Direct Deposit Enrollment/Change
Official Department of Veterans Affairs 29-0309 for Direct Deposit Enrollment/Change, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.