VA Form 10-10EZR
separate sheet of paper and attach to the application. If you have access to a copier, attach a copy of your insurance cards, Medicare card and/or Medicaid card (Medicaid is a federal/state health insurance program for certain low-income people).€Bring these cards with you to each health care appointment. Directions for Sections IV - V: ................
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- va form 10 10ezr