VA Form 21-2680
Send the medical section to a provider
Step 1 of 5
How this works
How this works (in progress)
Your section
Choose who completes it
Review and send
Confirmation
Step 1 of 5
How this works
Step 1 of 5: How this works
This form has two parts
You complete the first part. A medical provider completes the examination section. Both parts have to be finished before VA can review the form.
VA Form 21-2680 asks a doctor to describe how much help you need with everyday activities. Instead of printing the form, carrying it to an appointment, and mailing it back, you can send your provider a single-use link. They don't need a VA account and they only see the section they're asked to complete.
What your provider will see
- Your name and date of birth, so they can confirm who they're completing it for
- The 11 medical questions on Section II
- An attestation they sign before submitting
They cannot see the rest of your application, your other claims, or anything about your payments.
Your draft saves automatically.