You will need to submit the right form to the VA Health Administration Center depending on what you wish to do with CHAMPVA:
- VA Form 10-10d, Application for CHAMPVA Benefits
- VA Form 10-0426, Meds by Mail – Prescription Order Form
- VA Form 10-7959a, Claim Form (for beneficiaries, not providers)
- VA Form 10-7959c, Other Health Insurance Certification
Get PDF versions of the forms above at the VA HAC site.