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HealthcareForm 10-10EZ

VA Form 10-10EZ — Healthcare Application

The main form for enrolling in VA healthcare. Can be completed online, by phone, by mail, or in person.

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Tips

  • Online applications are processed in about 1-2 weeks
  • You can save your progress and return later
  • Have your DD-214 and insurance information ready
  • Financial information is optional but may expand your eligibility

Related Guides

Enrolling in VA Healthcare

Step-by-step guide to enrolling in VA healthcare, including medical, dental, and mental health services.