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Web print, fill out, and mail to. The information provided on this form will be used by va. For veterans to apply for enrollment in the va health care system. A va determination that an illness or injury was incurred or aggravated in the line of duty, in the active.
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This form is used by the united states department of veterans affairs. The information provided on this form will be used by va to determine your. The ensures that you're connecting to the official website and that any information you. Visit the nearest va medical center or clinic.
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A va determination that an illness or injury was incurred or aggravated in the line of duty, in.