A VA Form 10-2850A is known as an Application for Nurses and Nurse Anesthetists. The form is used by the United States Department of Veterans Affairs. This form will allow a nurse or nurse anesthetist to apply for recognition in the Veterans Health Administration. Being recognized by this organization will allow the nurse or nurse anesthetist to treat veterans under their VA health insurance.
This form requires detailed information about the medical professional in order to be approved. This will include information about the applicant’s qualifications, such as license or certification, education, or other experience. The Department of Veteran Affairs will verify all this information. To improve the chances of being recognized, include professional references and any honors or awards you have received related to your medical profession.
This form is commonly used by nurses and nurse anesthetists to become a part of the Veterans Health Administration.
The VA Form 10-2850a contains the following sections:
To complete a VA Form 10-2850a, you need to provide the following information:
If you need additional space, you should attach a separate sheet and refer to the items being answered by number.
The U.S. Department of Veterans Affairs is conducting this information collection to determine your qualifications for employment. It has authority to do so under Title 38, United States Code, Chapters 73 and 74. OMB Number 2900-0205.
The information provided on the form may be released without your prior consent to another U.S. government, state, or local agency, to the National Practitioner Data Bank which is administered by the Department of Health and Human Services, to State licensing boards, and other appropriate organizations or agencies.
Disclosure of your social security number is necessary to obtain the employment benefits that you are applying for. The VA is authorized to ask you for your SSN under Executive Order 9397, dated November 22, 1943.