Prior Financial Approval Request for Non Contracted Mental Health Programs

Form ID

This form is to be used for requesting prior financial approval for an eligible veteran to participate in a mental health program that is not under contract with the Department of Veterans’ Affairs (DVA).

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?
Form file format