Purpose and notices
The purpose of the notice, the Privacy Act notice citing 38 U.S.C. 7501 (VIOMPSP) and 7611 (HPSP), and the burden statement.
10-0491h
Notice of Approaching Graduation—Health Professional Scholarship Program (HPSP) & Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP)
- Agency
- VA
- Revision
- September 2026
- Fillable fields
- 18
- Pages
- 1
- Official source
- VA form page
- Checked
- October 20, 2026
VA Form 10-0491H: Notice of Approaching Graduation for HPSP and VIOMPSP
VA Form 10-0491H is the Department of Veterans Affairs Notice of Approaching Graduation for the Health Professional Scholarship Program (HPSP) and the Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP). The PDF itself is headed Notice of Expected Graduation. It is completed by a scholarship recipient, not by Veterans applying for benefits.
The form says its purpose is to prepare the assignment and location for recipients who need to complete a residency program or begin employment in a full-time clinical capacity at a VA facility in which the scholarship was awarded.
It is one page: the purpose and the Privacy Act and burden notices, the recipient's program and contact details, the expected degree and graduation date with a signature, an academic verification and graduation part completed after the degree requirements are met, and a certification. You can fill out the PDF free in your browser on this page and download the result without an account.
What's on VA Form 10-0491H
Program and contact details
A checkbox for HPSP, HPSP (Vet Center) or VIOMPSP, then name, Social Security number, phone, email and home address. The form notes that home address changes are updated in the VA-CEP portal.
Expected graduation
The expected degree and program of study and the expected date of graduation (MM/DD/YYYY), a statement verifying the information, and a signature and date.
Academic verification and graduation
Completed upon finishing the program of study or degree requirements: checkboxes for a copy of the transcript with the degree conferred date and an updated resume, uploaded into the application management system (AMS).
Certification and acknowledgment
Two statements on the accuracy of the information and on completing VHA qualification standards, residency programs and licensure before the obligated service period, then printed name, signature and date.
How to complete VA Form 10-0491H
- 1
Check your program
Mark HPSP, HPSP (Vet Center) or VIOMPSP at the top of the form.
- 2
Enter your contact details
Fill in your name, Social Security number, phone number, email address and home address.
- 3
Give your expected graduation
Enter the expected degree and program of study and the expected graduation date, check the verification statement, then sign and date.
- 4
After graduation, upload proof
The form says HPSP recipients complete the academic verification and graduation part and upload a copy of the transcript with the degree conferred date and an updated resume into AMS.
- 5
Certify and sign
Check both certification and acknowledgment statements, then print your name, sign and enter the date.
Why fill Form 10-0491h on indox
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
- Fill the form right in your browser, no software to install
- Free to fill and free to download, with no account
- The official blank straight from the VA, not a copy someone retyped
- Works on a phone, tablet or computer
Where it goes
Application management system
The form names the application management system (AMS) as where the graduation documents are uploaded. It prints no mailing address.
Address changes
The form says changes to the home address require the recipient to update their information in the VA-CEP portal.
Not by email
The burden statement says not to send the completed VA Form 10-0491h to [email protected], the address for comments on the burden estimate.
Edition
The PDF footer reads VA FORM SEP 2026 10-0491h, matching the September 2026 revision date on VA's page. It carries OMB Control No. 2900-0793, which expires 09/30/2029, and an estimated burden of 10 minutes.
Related forms
10-0491d
Education Program Completion Notice/Service Obligation Placement—Health Professional Scholarship Program (HPSP) & Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP)
15 fields, 1 page
10-0491j
Request for Deferment for Advanced Education—Health Professional Scholarship Program (HPSP) & Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP)
24 fields, 1 page
10-0491f
Health Professional Scholarship Program (HPSP) Agreement
13 fields, 4 pages
10-0491i
Notice of Change and/or Annual Academic Status—Health Professional Scholarship Program (HPSP) & Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP)
60 fields, 2 pages
10-0491c
Annual VA Employment or Deferment Verification—Health Professional Scholarship Program (HPSP) & Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP)
35 fields, 1 page
Who uses VA Form 10-0491H?
The form is for scholarship recipients nearing the end of their program of study.
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Questions about Form 10-0491h
What is VA Form 10-0491H?
It is the Notice of Approaching Graduation that HPSP and VIOMPSP scholarship recipients complete. The PDF is headed Notice of Expected Graduation.
Why does VA ask for this notice?
The form says its purpose is to prepare the assignment and location for recipients who need to complete a residency program or begin employment in a full-time clinical capacity at a VA facility.
When is the academic verification part completed?
The form says to complete it upon completing the program of study or degree requirements.
Which documents are uploaded after graduation?
A copy of the transcript with the degree conferred date and an updated resume, uploaded into the application management system (AMS).
Where do I update my home address?
The form says changes to the home address require the recipient to update their information in the VA-CEP portal.