Official VA Form

VA Form 10-2641

Authority for Issuance of Special and/or Experimental Appliances

VA Form 10-2641 — Authority for Issuance of Special and/or Experimental Appliances is an official U.S. Department of Veterans Affairs form. The current version was last revised 2008-06-06. It is 1 page 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: 2008-06-06
First issued: 2022-07-06
Pages: 1
Administered by: VHA

Frequently asked questions

What is VA Form 10-2641 used for?

Authority for Issuance of Special and/or Experimental Appliances. It is an official VA form, administered by VHA.

Where can I download the current VA Form 10-2641?

Download the official PDF from VA.gov here: https://www.va.gov/vaforms/medical/pdf/10-2641.pdf (last revised 2008-06-06).

How long is VA Form 10-2641?

VA Form 10-2641 is 1 page long, last revised 2008-06-06.

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 10-2636 — Envelope for Dental Radiograph - fillable

VA Form 10-2636A — Envelope for Panoramic Dental Radiographs

VA Form 10-2638 — Controlled Substance Administration Record

VA Form 10-2649A — Inter-Facility Transfer Form

VA Form 10-2649B — Provider Certification and Patient Consent for Transfer

VA Form 10-2675 — Consolidated Requisition for Cash Withdrawals - Order from SDC #F05239