Official VA Form

VA Form 10-0454

Military Treatment Facility Referral to VA Liaison

VA Form 10-0454 — Military Treatment Facility Referral to VA Liaison is an official U.S. Department of Veterans Affairs form. The current version was last revised 2017-11-09. It is 3 pages long. Download the up-to-date PDF below — BaseNeed syncs form data directly from VA.gov so you always get the current edition.

Download the official PDF (VA.gov) →

Last revised: 2017-11-09
First issued: 2022-12-08
Pages: 3
Administered by: VHA

Frequently asked questions

What is VA Form 10-0454 used for?

Military Treatment Facility Referral to VA Liaison. It is an official VA form, administered by VHA.

Where can I download the current VA Form 10-0454?

Download the official PDF from VA.gov here: https://www.va.gov/vaforms/medical/pdf/vha-10-0454-fill%20revised%2011-1-17%20corrected.pdf (last revised 2017-11-09).

How long is VA Form 10-0454?

VA Form 10-0454 is 3 pages long, last revised 2017-11-09.

Always the current version — synced from VA.gov. BaseNeed is not affiliated with the U.S. Department of Veterans Affairs.

You are not the first person to deal with this

BaseNeed is a members-only community for service members, veterans, spouses and their families. Nothing posted inside is public — not on Google, not on Facebook. That is the point: people talk about moves, money and paperwork there, and that only works behind a door.

Nearby form numbers

VA Form 10-0445 — Occupational and Environment Exposure History

VA Form 10-0451 — CONFLICT OF INTEREST DISCLOSURE FORM

VA Form 10-0453 — Screening Checklist (Appointee)- fillable

VA Form 10-0455 — Clinical Trial Annual Progress Report

VA Form 10-0455a — Clinical Trial Inclusion/Enrollment Report

VA Form 10-0459 — Credentialing Release of Information Authorization