Official VA Form

VA Form 10-2421

Prosthetic Authorization for Items or Services

VA Form 10-2421 — Prosthetic Authorization for Items or Services is an official U.S. Department of Veterans Affairs form. The current version was last revised 2007-02-21. It is 6 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: 2007-02-21
First issued: 2022-06-21
Pages: 6
Administered by: VHA

Frequently asked questions

What is VA Form 10-2421 used for?

Prosthetic Authorization for Items or Services. It is an official VA form, administered by VHA.

Where can I download the current VA Form 10-2421?

Download the official PDF from VA.gov here: https://www.va.gov/vaforms/medical/pdf/vha-10-2421-fill%20%20(1).pdf (last revised 2007-02-21).

How long is VA Form 10-2421?

VA Form 10-2421 is 6 pages long, last revised 2007-02-21.

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 10-2407 — Residential Care Home Program Sponsor Application

VA Form 10-2409 — Patient's Agreement with Hospital in Relation to Home Other Than His Own

VA Form 10-2410 — Agreement to Provide Home Care for Patient

VA Form 10-2431 — Request for Prosthetic Services - fillable

VA Form 10-2478 — Veterans Request for Refill of Medications and/or Medical Supplies

VA Form 10-2478a — Notice About Your Refill Request - fillable