VA Healthcare Enrollment

VA Form 10-10EZ

Application for Health Benefits

Enrolls a veteran in VA healthcare. Online application available at va.gov/health-care/apply.

Who files: Any veteran wanting to enroll in VA healthcare.
Next step: Most efficient submission is online at va.gov/health-care/apply. Paper form accepted at any VA medical facility.

Download from VA.gov Find a CVSO who can help file

In crisis? Call 988 and press 1 for the Veterans Crisis Line — 24/7 confidential, federally-operated. Text 838255. Chat at veteranscrisisline.net.

Related VA Healthcare Enrollment forms

About this form catalog

This is part of a 22-form catalog covering disability claims, appeals, representation, education benefits, healthcare, housing, pension, and records access — maintained by Wounded Warriors. Every entry includes the official VA download URL, plain-English description, who-files-it, and next-step routing to free claims help (CVSOs and VSOs). Free to use under CC-BY 4.0. Browse all forms → · Find a free CVSO →

This page is informational only and is not a VA-affiliated source. The official form is hosted at va.gov.