Request for Provision of Attendant Care Services by a Partner, Relative or Friend

Form ID: 
D9371
Audience: 
General

This form is to confirm that exceptional circumstances exist requiring a partner, relative or friend to provide Attendant Care Services to an approved client with the Department of Veterans’ Affairs (DVA). This form is only to be completed following a request from the client to DVA to consider exceptional circumstances.

How can I access this form?: 
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