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VA Veterans Forms

Official-source Department of Veterans Affairs forms for benefits, healthcare, education, disability, and records requests.

703 fillable formsOfficial source linksUpdated May 14, 2026

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 VA form edition and benefit program before filing.
  • Attach service records, medical evidence, dependency records, or authorization documents when required.
  • Save a complete copy of the submission packet for follow-up.

703 VA Forms

Page 11 of 30

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.

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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.

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VA Form 10-2407(2025)

Residential Care Home Program Sponsor Application

Official Department of Veterans Affairs 10-2407 for Residential Care Home Program Sponsor Application, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.

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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.

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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.

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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.

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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.

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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.

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VA Form 10-2478A(1978)

Notice About Your Refill Request - fillable

Official Department of Veterans Affairs 10-2478A for Notice About Your Refill Request - fillable, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.

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VA Form 10-2479C(2011)

Request for Web Survey or Form Number - fillable

Official Department of Veterans Affairs 10-2479C for Request for Web Survey or Form Number - fillable, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.

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VA Form 10-250(2019)

VHA Research Protocol Privacy Review Checklist

Official Department of Veterans Affairs 10-250 for VHA Research Protocol Privacy Review Checklist, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.

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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.

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VA Form 10-252(2020)

Authorization to Release Protected Health Information to State/Local Public Health Authorities

Official Department of Veterans Affairs 10-252 for Authorization to Release Protected Health Information to State/Local Public Health Authorities, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.

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VA Form 10-2520(2008)

Prosthetic Service Card Invoice

Official Department of Veterans Affairs 10-2520 for Prosthetic Service Card Invoice, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.

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VA Form 10-253(2020)

Ecclesiastical Endorsement for Veterans Affairs Chaplaincy

Official Department of Veterans Affairs 10-253 for Ecclesiastical Endorsement for Veterans Affairs Chaplaincy, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.

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VA Form 10-2553(2019)

Certificate of Residency

Official Department of Veterans Affairs 10-2553 for Certificate of Residency, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.

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VA Form 10-2553A(2019)

Certificate of Internship

Official Department of Veterans Affairs 10-2553A for Certificate of Internship, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.

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VA Form 10-2570(2007)

VA Staff Dental Outpatient Record

Official Department of Veterans Affairs 10-2570 for VA Staff Dental Outpatient Record, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.

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VA Form 10-2570G(2015)

Dental Outpatient Emergency-Referral & Treatment - Order from SDC #F04736

Official Department of Veterans Affairs 10-2570G for Dental Outpatient Emergency-Referral & Treatment - Order from SDC #F04736, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.

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VA Form 10-259(2021)

Revocation of Authorization for Release of Release of Individually-Identifiable Health Information

Official Department of Veterans Affairs 10-259 for Revocation of Authorization for Release of Release of Individually-Identifiable Health Information, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.

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VA Form 10-2596(1996)

Identification Tag

Official Department of Veterans Affairs 10-2596 for Identification Tag, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.

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VA Form 10-2614D-2A(1992)

Report of Seizure - Medical Record

Official Department of Veterans Affairs 10-2614D-2A for Report of Seizure - Medical Record, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.

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VA Form 10-2614D-3A(2000)

Medical Record Allergy Treatment

Official Department of Veterans Affairs 10-2614D-3A for Medical Record Allergy Treatment, sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.

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VA Form 10-2614F(1970)

Weight Chart (Clinical Record)

Official Department of Veterans Affairs 10-2614F for Weight Chart (Clinical Record), sourced from the VA public forms catalog for veterans benefits, health care, education, records, and service-related workflows.

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