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Complete only the sections that apply to you; Indicate your race and ethnicity, as well as if you are spanish, hispanic, or latino in origin. This form will be completed by veterans who wish to become covered under the va health care system. This form is used by the united states department of veterans affairs. Veterans who require assistance completing.
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Type of benefit applying for: Sign and date the form. Use this form to update your personal, financial, or insurance information after you're enrolled in va health care. Web what is a va form 10 10ez?
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Where can i get help filling out the form and if i have questions? The va uses the information provided on the form to determine the veteran’s eligibility for medical benefits.