Apply for the Program of Comprehensive Assistance for Family Caregivers
Use this form to apply for the Program of Comprehensive Assistance for Family Caregivers. Veterans can also use this application to add or change caregivers after they apply.
Start your applicationFollow these steps to get started:
Check your eligibility
Check our eligibility requirements before you apply.
Find out if you’re eligible for the Program of Comprehensive Assistance for Family Caregivers
Gather your information
You’ll need this information for the Veteran and each family caregiver:
- Social Security number or tax identification number
- Date of birth, address, and phone number
You’ll also need to share the VA medical center where the Veteran receives care or plans to receive care.
And if you’re a representative signing this application on behalf the Veteran, you’ll need to submit a document showing you have legal authority to make decisions for the Veteran (like a valid power of attorney, legal guardianship order, or other legal document). Or you’ll need to upload a document showing you have authority to fill out and sign applications on behalf of the Veteran.
Learn more about the documents you can submit
What if I have questions or need help with this application?
If you have questions or need help, here’s what you can do:
- Call the Caregiver Support Line at
( ) and ask for help filling out the form. - Find a Caregiver Support Team Coordinator at your nearest VA health facility. Go to our Caregiver Support Program Teams directory
- Get help from an accredited representative, like a Veterans Service Organization (VSO). Learn more about getting help from an accredited representative
Start your application
We’ll take you through each step of the process. It should take about 15 minutes.
If the Veteran is already enrolled in this program and wants to add a new family caregiver, the Veteran and the new caregiver can use this application.
Note: There can only be 1 Primary and up to 2 Secondary Family caregivers at any one time.
The Paperwork Reduction Act: This information collection is in accordance with the clearance requirements of section 3507 of the Paperwork Reduction Act of 1995. Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time to read instructions, gather necessary data, and fill out the form. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Completion of this form is mandatory for individuals who wish to participate in the Program of Comprehensive Assistance for Family Caregivers.
Privacy Act information: VA is asking you to provide the information on this form under 38 U.S.C. Sections 101, 5303A, 1705, 1710, 1720B, 1720G, 1725 and 1781 in order for VA to determine your eligibility for medical benefits. Information you supply may be verified through a computer-matching program. VA may disclose the information that you put on the form as permitted by law. VA may make a "routine use" disclosure of the information as outlined in the Privacy Act systems of records, “Patient Medical Records --VA” (24VA10P2), “Enrollment and Eligibility Records --VA” (147VA10NF1), and “Veterans and Beneficiaries Purchased Care Community Health Care Claims, Correspondence, Eligibility, Inquiry and Payment Files - VA” (54VA10NB3) and in accordance with the VHA Notice of Privacy Practices. Providing the requested information, including Social Security Number, is voluntary, but if any or all of the requested information is not provided, it may delay or result in denial of your request for health care benefits. Failure to furnish the information will not have any effect on any other benefits to which you may be entitled. If you provide VA your Social Security Number, VA will use it to administer your VA benefits. VA may also use this information to identify Veterans and persons claiming or receiving VA benefits, and their records, and for other purposes authorized or required by law.
If you have trouble using this online application, call our MyVA411 main information line at
You can call the VA Caregiver Support Line at
You can call the Enrollment and Eligibility Division of the Health Eligibility Center at