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- VA Form 10-10d. APPLICATION FOR CHAMP V. A. BENEFITS.
Get VA Form 10-10d. APPLICATION FOR CHAMP V. A. BENEFITS.
, PO Box 469028, Denver CO 80246-9028 Customer Service Center: 1-800-733-8387 FAX: 303-331-7809 ATTENTION: Please refer to the information on the following pages for assistance completing this form in its entirety (print or type only). Return the form and any additional, requested information to the address shown above. If applicants indicate in Section II that they have Medicare or other health insurance, each applicant must submit VA Form 10-7959c, CHAMPVA Other Health Insurance (OHI) Certif.
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