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VA Form 10-10CG
Form name:
Application for Comprehensive Assistance for Family Caregivers Program
Form revision date:
May 2024
Related to:
Family member benefits, Health care
When to use this form
Use VA Form 10-10CG to apply for the Program of Comprehensive Assistance for Family Caregivers. Each time a new caregiver is appointed, a new VA Form 10-10CG is required.
Downloadable PDF
Online tool
You can apply online instead of filling out and sending us the paper form.
If you’re the spouse or child of a Veteran with disabilities, or the surviving spouse or child of a Veteran who has died, use VA Form 10-10d to apply for health insurance through CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs).
You’re applying for CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs), and have other health insurance to declare as part of your VA Form 10-10d application, or
You’re already enrolled in CHAMPVA and need to report changes in your other non-VA health insurance, such as new beneficiaries or coverage changes. In this case, be sure to wait until you receive your enrollment packet in the mail before you submit this form.
If you applied for CHAMPVA benefits by mail,download the PDF version of this form and send it to us by mail.
If you applied for CHAMPVA benefits online,use our online tool to submit this form online.
Helpful links related to VA Form 10-10CG
Find out if you may be eligible for the Program of Comprehensive Assistance for Family Caregivers. This program offers support and services for caregivers of eligible Veterans in any branch or service era who have a serious injury or illness caused or made worse by their active-duty service.
Find out if you qualify for health care through our CHAMPVA program, the Defense Department’s TRICARE program, or 1 of our programs related to a Veteran’s service-connected disability.
