This is a legal form that was released by the U.S. Department of Veterans Affairs on January 1, 2017 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is VA Form 10-2649B?
A: VA Form 10-2649B is a document used to certify providers and obtain patient consent for transfer.
Q: Who uses VA Form 10-2649B?
A: This form is used by healthcare providers and patients in the VA healthcare system.
Q: What is the purpose of VA Form 10-2649B?
A: The purpose of this form is to ensure that providers are certified and that patients give their consent before being transferred.
Q: What information is required on VA Form 10-2649B?
A: The form requires information such as the provider's certification details, patient's personal information, and their consent for transfer.
Form Details:
Download a fillable version of VA Form 10-2649B by clicking the link below or browse more documents and templates provided by the U.S. Department of Veterans Affairs.