United States · VA
VA Form 10-10EZ — Application for Health Benefits
VA Form 10-10EZ enrolls veterans in VA health care, covering service history, income and insurance details.
Fill 10-10EZ now — free to try
Filled entirely on your computer. Your SSN and personal details are never uploaded.
Who needs 10-10EZ?
Veterans applying for VA health care enrollment, including those recently separated from service.
How to fill it with DocsArc
- Open 10-10EZ in the DocsArc workspace with one click above.
- Click any field and type — form fields are detected automatically, and you can add text anywhere.
- Sign it if needed: draw, type or upload your signature, with an automatic date line.
- Save or print. The finished PDF never left your computer.
Frequently asked questions
Can I apply online instead?
Yes — VA.gov offers online enrollment; the PDF suits applicants who prefer to mail or deliver the form to a VA medical center.
Always verify you have the current version: official VA page
This U.S. federal form is in the public domain. DocsArc is an independent tool and is not affiliated with VA.