VA Palo Alto Health Care System
Veterans Care Agreement
A Veterans Care Agreement (VCA) is a non-contract agreement to purchase care not available under an existing VA community care network. In these cases, effective October 1, 2019, VCAs will be required to continue our partnership in serving our Veterans; we can no longer authorize care without this agreement.
A complete VCA packet includes the following:
- Veterans Care Agreement (VA Form 10-10171)
- VA-FSC Vendor File Request Form
- Request for Taxpayer Identification Number and Certification (W-9)
- Copy of practice license
- Copy of DEA license (if applicable)
- Taxonomy code
Please sign all forms and send your complete packet to the VAPAHCS Office of Community Care via:
- Email: V21PALVeteranCareAgreements@va.gov (preferred)
- Fax: (650) 614-9901, or
- Mail: VAPAHCS Office of Community Care (136C); 795 Willow Road; Menlo Park, CA 94025
If you have any questions regarding this process, please contact the VAPAHCS Community Care line at (650) 617-2732 or via email. We appreciate your continued support of our mission to provide quality health care to Veterans and look forward to partnering with you!
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