DEPARTMENT OF VETERANS AFFAIRS
Medical Center
1700 South Lincoln Avenue
Lebanon PA 17042

"THANK YOU FOR INQUIRY REGARDING
VETERANS HEALTH CARE BENEFITS. "

Once you have completed the application for medical benefits, please return the application in the envelope provided with a copy of your Active Duty Military Discharge Paper (DD214).

If additional information is needed, please call:
Sue Fike
Enrollment Specialist
717-228-6000 Phone
1-800-409-8771 EXT 6000 Toll Free

Instructions:

The enrollment forms can be downloaded in .zip file format or as individual pages
(a total of 4) for printing.

	vetsaffairs	1.7 Mb
	va_formA1	455.7 Kb
	va_formA2	495.7 Kb
	va_formB1	397.0 Kb
	va_formB2	441.9 Kb