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NOTE: The Request for Services (RFS) Form 10-10172 must be submitted via an approved method (HSRM, Electronic Fax, Direct Messaging, Traditional Fax, or Mail) to your local VA community care office. Completion of this form is REQUIRED and MUST BE SIGNED by the requesting provider for further care to be rendered to a Veteran patient.
18 cze 2024 · Download VA Form 10-10172 (PDF) Helpful links Find out how to update your direct deposit information online for disability compensation, pension, or education benefits.
The Request for Services (RFS) Form 10-10172 must be submitted via an approved method (HSRM, Electronic Fax, Direct Messaging, Traditional Fax, or Mail) to your local VA community care office. Completion of this form is REQUIRED and MUST BE SIGNED by the requesting provider for further care to be rendered to a Veteran patient. NOTE: 1.
Download Fillable Va Form 10-10172 In Pdf - The Latest Version Applicable For 2024. Fill Out The Request For Services (rfs) Form Online And Print It Out For Free. Va Form 10-10172 Is Often Used In Request For Service, U.s. Department Of Veterans Affairs, United States Federal Legal Forms, Legal And United States Legal Forms.
VA Form 10-10172, also known as the Community Care Provider-Request for Service (RFS), is a form used by Veterans to request additional services or continued care from the Department of Veterans Affairs (VA).
Community Care Provider-Request for Service (RFS), VA Form 10-10172, is used to request additional services or continued care from VA. The requested care may be performed within VA or in the community based on a Veterans eligibility.
requested service - one service per form (Separate Form Required for Each Service Requested) If care is needed within 48 hours or if Veteran is at risk for Suicide/Homicide, please call the VA directly .
