Vf1015x032 2025

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The document outlines the process for requesting additional services under the VA Patient-Centered Community Care and Veterans Choice Program. It includes sections for indicating the request priority (routine or urgent), providing veteran and provider information, detailing service types, and specifying requested service details. The document emphasizes confidentiality and provides instructions for handling errors in transmission.

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Versions	Form popularity	Fillable & printable
2016	4.8 Satisfied (118 Votes)

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