Get Va Fax Cover Sheet

The Va Fax Cover Sheet is an essential document for veterans seeking reimbursement for medical services received outside the United States. This guide provides you with clear, step-by-step instructions to help you fill out the form accurately and efficiently.

Follow the steps to complete the Va Fax Cover Sheet online

1. Click ‘Get Form’ button to secure the Va Fax Cover Sheet and open it for filling.
2. In Section I, enter your veteran information including your name (last, first, middle initial), VA claim number, social security number, date of birth (formatted as mm/dd/yyyy), telephone number (including international prefixes), mailing address, and email address. Note that items are marked mandatory.
3. Proceed to Section II and provide details regarding your diagnosis or the nature of illness or injury. Ensure to include the itemized billing statement from your provider, outlining the following: diagnoses treated, a narrative description of each service, billed charge for each service, and the date(s) of service.
4. Also include the provider information, which must have the provider's full name, medical title, office address, office telephone number, and billing address if it differs from the office address.
5. Next, select whether payment should be sent to you (the veteran) or your provider by checking the appropriate box.
6. After ensuring all fields are accurately completed, review your information for any errors or omissions.
7. Finally, save your changes, then download, print, or share the completed form as necessary.

Complete your Va Fax Cover Sheet online today to ensure timely processing of your claim.