60.4—Application.

To obtain temporary lodging under this part, a veteran must make an application to the person responsible for coordinating the temporary lodging program at the VA health care facility of jurisdiction. This may be done by letter, electronic means (including telephone, e-mail, or facsimile), or in person at the VA health care facility of jurisdiction. The veteran shall provide the following information:
(a) Veteran's name;
(b) Beginning date and time and duration of scheduled care;
(c) Type of scheduled care;
(d) Name, gender, and relationship to the veteran of person accompanying veteran;
(e) Requested dates for temporary lodging;
(f) Distance, time, and means of travel from the veteran's home to VA health care facility;
(g) Circumstances that may affect the time of travel from the veteran's home to VA health care facility; and
(h) A statement that the veteran is medically stable and capable of self-care or will be accompanied by a caregiver able to provide the necessary care.

Code of Federal Regulations

(Authority: 38 U.S.C. 501, 1708 )
(The Office of Management and Budget has approved the information collection requirements in this section under control number 2900-0630)