Get Va 10-0423 2004-2026

Filling out the VA 10-0423 form is crucial for individuals volunteering as drivers for the Veteran Transportation Network. This guide provides clear instructions on how to complete this form online, ensuring that all required information is accurately submitted.

Follow the steps to fill out the VA 10-0423 form online.

1. Click 'Get Form' button to obtain the VA 10-0423 form and open it in the editor.
2. Enter your name in the designated field. Ensure that it matches your legal name as per identification documents.
3. Provide your Social Security number. This information is essential for verification and record-keeping.
4. Fill in your date of birth. Use the format required by the form to avoid any confusion.
5. Review the vision criteria. Clinicians must complete the visual acuity and visual field testing section and mark whether you pass or fail.
6. Complete the hearing loss section. Indicate whether you meet the hearing standards required to drive.
7. Fill out the diabetes criteria, confirming whether you have a clinical diagnosis and if your HbA1c is within the acceptable range.
8. Provide details for the substance abuse history, if applicable. Include documentation if required.
9. Ensure to complete all other health criteria, which includes checking for conditions like epilepsy, hypertension, and others listed.
10. Once all sections are filled, review your information for accuracy. Correct any errors identified.
11. Submit the completed form by following the online submission process provided in the platform.
12. After submission, save a copy of the completed form for your records, and consider downloading or printing it if required.

Start filling out the VA 10-0423 online today to support our veterans.