Instructions

The first step to a VAC flight is submitting this travel request form. While not all fields are required, any additional information you can provide will speed up the process.

Please Note: not all fields may apply to you. If you represent an agency, organization or healthcare facility that is making the request on behalf of the veteran, please provide the appropriate information. Family members and friends need not complete the Agency or Health Care facility fields.

Beneficiary Information




Trip Requestor Contact Information

Preferred
Preferred
Preferred
*At least one phone number is required.


Family/Friend
Agency/Organization

Travel Needs
One Way
Round Trip


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Calendar Icon Clear


At Origin
At destination
* Please enter a brief explaination below noting the reason for the travel request. (And any additional information which would be helpful.)


I accept

* Required Field