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Get Va Form 10 2641

Requests for other than a standard full electric hospital bed will be referred to VACO for approval on VA Form 10-2641 Authority for Issuance of Special and/or Experimental Appliance through the VISN Prosthetic evidence to support the medical need for specialized equipment. The Prosthetic Service will complete VA Form 10-2641 and submit to VACO. IV. INDICATIONS The patient s condition requires positioning of the body e.g. to alleviate pain promot.

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Keywords relevant to Va Form 10 2641

  • DME
  • contractures
  • Tetraplegia
  • HCFA
  • PSAs
  • 2004
  • VISN
  • DMERC
  • Paraplegia
  • 02a
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