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Form name: Instructions and Enrollment Application for Health Benefits
  • .This regulation supersedes AR 600–8–10, 31 July 2003. This edition publishes a rapid action revision of AR 600–8–10. AR 600–8–10 † 15 February 2006/RAR 4 August 2011 i.
  • Title: Para # 28 (pdf) Author: www.alkalam.pk Subject: Al-Qur'an Indo-Pak Style Created Date: 5/18/2004 12:54:42 PM.

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Form last updated: January 21, 2020

When to use this form

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Use VA Form 10-10EZ if you’re a Veteran and want to apply for VA health care. You must be enrolled in VA health care to get care at VA health facilities or to have us cover your care at a community care provider (an approved non-VA provider).

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Downloadable PDF

Download VA Form 10-10EZ (PDF)

Online tool

You can apply online instead of filling out and sending us the paper form.

Related forms and instructions

Para No 10 Pdf

  • VA Form 10-10EZ (esp)

    Form name: Instrucciones y Solicitud de Beneficios Medicos

    Para que los Veteranos soliciten su afiliación al sistema de atención médica de VA. la información proporcionada en este formulario será utilizada por VA para determinar si usted reúne los requisitos para recibir beneficios médicos.

    Download VA Form 10-10EZ (esp) (PDF)

  • VA Form 10-10EZR

    Form name: 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, or financial information.

    Download VA Form 10-10EZR (PDF)

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