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Click ‘Get Form’ to open the Direct Order Form in the editor.
Begin by filling out the Provider Details section. Enter your name, provider number, employer, and contact information including phone and email.
Next, complete the Entitled Person/Delivery Details. Input the surname, given names, date of birth, DVA file number, and card type. Indicate if the entitled person resides in a Residential Aged Care Facility.
If applicable, provide Hospital Discharge Details by specifying if an item is required for discharge and entering the discharge date.
In the Order Details section, refer to the RAP Schedule of Equipment for product specifications. Fill in the product catalogue number, size, type, specifications, and quantity needed.
Finally, certify that you have clinically assessed the client by signing and dating at the bottom of the form.
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VA form 10-0708List of VA formsVA Request for services form PDFVA Form 10-10EZDepartment of Veterans Affairs Provider phone numberVA form 5103 PDFVA Form 0857cVA Form 5103 download
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Dec 15, 2025 Search for a VA form by keyword, form name, or form number. You can now do many form-based tasks online, like filing a disability claim. GI
Veterans Benefits Administration provides financial and other forms of assistance to Veterans, their dependents and caretakers. Support: 1-800-827-1000 GI Bill
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