Follow the steps to complete your application for CHAMPVA benefits.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin with Section I, which requires the sponsor's information. Fill in the veteran's last name, first name, middle initial, social security number, and VA file number. Provide the complete street address, telephone number, city, state, and zip code.
3. Continue with the date of birth, date of marriage, and, if applicable, the date of death of the veteran. Indicate whether the veteran died while on active military service with a simple 'Yes' or 'No'.
4. Move on to Section II for applicant information. Fill out the last name, first name, middle initial, and social security number. Select your sex and indicate if the veteran is deceased. Provide your email address and telephone number, followed by your complete address.
5. If applicable, indicate if you are enrolled in Medicare. If yes, complete and attach VA Form 10-7959c and include a copy of your Medicare card.
6. Specify your relationship to the veteran in the designated area, such as spouse or child. Repeat the process for additional applicants by providing their personal details and attachment requirements as needed.
7. In Section III, certify that the information is correct by signing and dating the application. If someone else fills it out for you, they must provide their details as well.
8. Once all sections are filled, review the application for accuracy. You can then save any changes. Depending on your preference, download, print, or share the completed form.

Complete your application online today to ensure your eligibility for CHAMPVA benefits.