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
Page 9 of 15
SF 600(2026)
Medical Record - Chronological Record of Medical Care
Official General Services Administration SF 600 form for Medical Record - Chronological Record of Medical Care. This federal form supports healthcare workflows and is sourced from the GSA forms library.
SF 601(2026)
Immunization Record
Official General Services Administration SF 601 form for Immunization Record. This federal form supports healthcare workflows and is sourced from the GSA forms library.
SF 602(2026)
Medical Record - Serology Record
Official General Services Administration SF 602 form for Medical Record - Serology Record. This federal form supports healthcare workflows and is sourced from the GSA forms library.
SF 603(2026)
Medical Record - Dental
Official General Services Administration SF 603 form for Medical Record - Dental. This federal form supports healthcare workflows and is sourced from the GSA forms library.
SF 603A(2026)
Medical Record - Dental - Continuation
Official General Services Administration SF 603A form for Medical Record - Dental - Continuation. This federal form supports healthcare workflows and is sourced from the GSA forms library.
SF 88(2026)
Medical Record - Report of Medical Examination
Official General Services Administration SF 88 form for Medical Record - Report of Medical Examination. This federal form supports healthcare workflows and is sourced from the GSA forms library.
SF 93(2026)
Report of Medical History
Official General Services Administration SF 93 form for Report of Medical History. This federal form supports healthcare workflows and is sourced from the GSA forms library.
SSA Form SSA-1021(2026)
Appeal of Determination for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1021)
Official Social Security Administration SSA-1021 form for Appeal of Determination for Extra Help with Medicare Prescription Drug. This verified federal form supports Social Security benefits, disability, SSI, Medicare, representative, appeal, records, or wage workflows from the SSA public forms library.
SSA Form SSA-268(2026)
Patient Acknowledgement Form for Influenza Vaccination (SSA-268)
Official Social Security Administration SSA-268 form for Patient Acknowledgement Form for Influenza Vaccination. This verified federal form supports Social Security benefits, disability, SSI, Medicare, representative, appeal, records, or wage workflows from the SSA public forms library.
SSA Form SSA-4814(2026)
Medical Report on Adult with Allegation of Human Immunodeficiency Virus (HIV) Infection (SSA-4814)
Official Social Security Administration SSA-4814 form for Medical Report on Adult with Allegation of Human Immunodeficiency Virus. This verified federal form supports Social Security benefits, disability, SSI, Medicare, representative, appeal, records, or wage workflows from the SSA public forms library.
SSA Form SSA-4815(2026)
Medical Report on Child with Allegation of Human Immunodeficiency Virus (HIV) Infection (SSA-4815)
Official Social Security Administration SSA-4815 form for Medical Report on Child with Allegation of Human Immunodeficiency Virus. This verified federal form supports Social Security benefits, disability, SSI, Medicare, representative, appeal, records, or wage workflows from the SSA public forms library.
VA 10-10EZ(2025)
Application for Health Benefits
Department of Veterans Affairs form used to apply for VA healthcare benefits.
VA Form 10-0114J-15(2024)
VAAES ACUTE INPATIENT NSG SHIFT ASSESSMENT - BEDSIDE SWALLOW SCREEN
Official Department of Veterans Affairs 10-0114J-15 for VAAES ACUTE INPATIENT NSG SHIFT ASSESSMENT - BEDSIDE SWALLOW SCREEN, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-0114J-2(2025)
VAAES ACUTE INPATIENT NSG ADMISSION SCREENING
Official Department of Veterans Affairs 10-0114J-2 for VAAES ACUTE INPATIENT NSG ADMISSION SCREENING, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-0114J-3(2025)
VAAES MENTAL HEALTH NSG ADMISSION SCREENING
Official Department of Veterans Affairs 10-0114J-3 for VAAES MENTAL HEALTH NSG ADMISSION SCREENING, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-0114J-4(2025)
VA-APPROVED ENTERPRISE STANDARD ACUTE INPATIENT NSG SHIFT ASSESSMENT
Official Department of Veterans Affairs 10-0114J-4 for VA-APPROVED ENTERPRISE STANDARD ACUTE INPATIENT NSG SHIFT ASSESSMENT, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-0114J-7(2026)
VA-APPROVED ENTERPRISE STANDARD ACUTE NURSING FREQUENT DOCUMENTATION - AGITATED BEHAVIOR SCALE (ABS - TBI Patients Only)
Official Department of Veterans Affairs 10-0114J-7 for VA-APPROVED ENTERPRISE STANDARD ACUTE NURSING FREQUENT DOCUMENTATION - AGITATED BEHAVIOR SCALE (ABS - TBI Patients Only), sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-0137(2021)
VA Advance Directive: Durable Power of Attorney for Health Care and Living Will
Use VA Form 10-0137 to give specific people permission to make health care decisions for you, and to let VA health care providers know your wishes for medical, mental health, long-term, and other types of care.
VA Form 10-0137A(2018)
What You Should Know About Advance Directives
Use this form to learn about your rights to accept or refuse medical treatment, and to complete a power of attorney for health care or a living will.
VA Form 10-0246(2013)
Veteran Patient Statement
Official Department of Veterans Affairs 10-0246 for Veteran Patient Statement, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-0386(2012)
VHA Choice Approval for Medical Care
Official Department of Veterans Affairs 10-0386 for VHA Choice Approval for Medical Care, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-0388-4(2013)
State Home Construction Grant Program Space Analysis-Adult Day Health Care
Official Department of Veterans Affairs 10-0388-4 for State Home Construction Grant Program Space Analysis-Adult Day Health Care, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-0400(2002)
Request for Veterans Service Organization (VSO) Access to Computer Patient Record System (CPRS) Read Only
Official Department of Veterans Affairs 10-0400 for Request for Veterans Service Organization (VSO) Access to Computer Patient Record System (CPRS) Read Only, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.
VA Form 10-0400A(2002)
Computer Patient Record System (CPRS) Read Only Rules of Behavior for Veterans Service Organization (VSO)
Official Department of Veterans Affairs 10-0400A for Computer Patient Record System (CPRS) Read Only Rules of Behavior for Veterans Service Organization (VSO), sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.