Health Care Form

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

"THANK YOU FOR INQUIRY REGARDING

VETERANS HEALTH CARE BENEFITS. "

 

Instructions:

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

The enrollment form can be completed and printed by selecting:  https://www.1010ez.med.va.gov/sec/vha/1010ez/Form/1010ez.pdf

 

Application, along with a copy of the veteran’s military discharge (DD-214) and all health insurance/Medicare cards should be mailed to:
Means Test Clerk (136A)
1700 S. Lincoln Avenue
Lebanon, PA  17042