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Department of Veterans Affairs Veterans Health Administration Washington, DC 20420VHA HANDBOOK 1121.01 Transmittal Sheet September 17, 2008, VIA EYE CARE1. REASON FOR ISSUE. This Veterans Health Administration
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Who needs VHA HBK 1121 VHA:

01
Veterans who are seeking healthcare services or benefits from the Veterans Health Administration (VHA) may need to fill out VHA HBK 1121 VHA.
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Individuals who are part of the VHA healthcare system and require certain medical treatments, medications, or specialized care may be required to complete VHA HBK 1121 VHA.
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VHA HBK 1121 VHA may be necessary for veterans or their authorized representatives to access specific healthcare programs, including but not limited to mental health services, rehabilitation services, or long-term care options provided by the VHA.
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Veterans who are applying for or inquiring about financial assistance, insurance coverage, or other benefits related to their healthcare from the VHA may need to fill out VHA HBK 1121 VHA as part of the application process.

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VHA HBK 1121 VHA is a form used for reporting certain financial information.
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