VA Form 10-10172. Community Care Provider - Request for Service: Fill out & sign online

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See more VA Form 10-10172. Community Care Provider - Request for Service versions

We've got more versions of the VA Form 10-10172. Community Care Provider - Request for Service form. Select the right VA Form 10-10172. Community Care Provider - Request for Service version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
VA Form 10-10172 2021	4.8 Satisfied (46 Votes)
VA Form 10-10172 2019	4.3 Satisfied (261 Votes)

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How do I submit a referral to the VA?

Call 1-877-222-8387.

How do I apply for veterans benefits?

Visit the Veteran Readiness and Employment (VR&E) website. The best way to file for disability compensation is to apply online at www.va.gov/disability. Or, you can fax it to: (844) 531-7818 (inside the U.S.)

What is a VA Form 21?

VA Form 21, APPLICATION FOR ACCREDITATION AS SERVICE ORGANIZATION REPRESENTATIVE.

What is an RFS form for VA?

Request for Service (RFS) Requirements The purpose of the Community Care Provider-Request for Service, VA Form 10-10172, is to manage requests from community providers and to allow for placement, tracking, managing, and reporting of those requests. Approved care may be performed within VA or at community facilities.

What is a VA 10 form?

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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