Official VA Form

VA Form 10-10SH

State Home Program Application for Veteran Care Medical Certification

VA Form 10-10SH — State Home Program Application for Veteran Care Medical Certification is an official U.S. Department of Veterans Affairs form. The current version was last revised 2021-07-16. It is 5 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: 2021-07-16
First issued: 2024-03-15
Pages: 5
Administered by: VHA

Frequently asked questions

What is VA Form 10-10SH used for?

State Home Program Application for Veteran Care Medical Certification. It is an official VA form, administered by VHA.

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

Download the official PDF from VA.gov here: https://www.va.gov/vaforms/medical/pdf/VA%20Form%2010-10SH.pdf (last revised 2021-07-16).

How long is VA Form 10-10SH?

VA Form 10-10SH is 5 pages long, last revised 2021-07-16.

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 10-10EZR — INSTRUCCIONES PARA COMPLETAR EL FORMULARIO DE ACTUALIZACIÓN DE LOS BENEFICIOS MÉDICOS

VA Form 10-10HS — Request for Hardship Determination

VA Form 10-10M — Medical Certificate

VA Form 10-1170 — Application for Furnishing Long-Term Care to Beneficiaries of Veteran Affairs

VA Form 10-1223 — Report of Subcommittee on Human Studies

VA Form 10-1245C — VA/Department of Defense Sharing Agreement