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Use VA Form 21-4142 to give us permission to obtain your personal information from a non-VA source like a private doctor or hospital. Examples of personal information may include your medical treatment, hospitalizations, psychotherapy, or outpatient care.
NOTE: Use VA Form 21-674b, School Attendance Report, to report to VA any change in the childs status, such as termination of school attendance or marriage.
VA Form 21, APPLICATION FOR ACCREDITATION AS SERVICE ORGANIZATION REPRESENTATIVE.
Use VA Form 22-5495 to request changes to your education benefits if youre using one of these programs: Survivors and Dependents Educational Assistance (DEA) program, or. Fry Scholarship.
Use VA Form 22-5490 when a spouse or dependent is applying for educational benefits under Chapter 35 Survivors and Dependents Education Assistance (DEA) or Chapter 33 Fry Scholarship.
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Fill out VA Form 21-2680 (Examination for Housebound Status or Permanent Need for Regular Aid and Attendance) and mail it to the PMC for your state. You can have your doctor fill out the examination information section.

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