Optical treatment prior financial approval request
Form ID
D1399
Audience
For providers
Optometrist, Orthoptist and Optical dispenser
Used for requesting prior financial approval to provide optical services/items to eligible veterans.
If you are using an Apple computer and want to fill out your form electronically, please download the form and open it with Acrobat 7 or later.
How can I access this form?
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Form (PDF or Word)