Items 1 to 5: bidder and shop
Name of bidder, full business name of the shop if different, the shop's complete address, any trade name, and its days and hours of business.
VA2793
Shop Data Sheet (Artificial Limbs)
- Agency
- VA
- Revision
- March 2002
- Fillable fields
- 73
- Pages
- 2
- Official source
- VA form page
- Checked
- October 20, 2026
VA Form VA2793: Shop Data Sheet (Artificial Limbs)
VA Form VA2793 is the U.S. Department of Veterans Affairs Shop Data Sheet (Artificial Limbs). The form says it is completed and submitted by the bidder, in duplicate for each shop owned and operated by the bidder and for all branch shops and shops of the bidder's agents at which service will be performed under the contract. VA checks the data for accuracy, and the form says it will be used to assist VA in evaluating the facility.
The form is two pages. Page 1 asks about the bidder and the shop, experience and references, staff and their prosthetics training, the premises and the shop equipment, and ends with a certification. Page 2 is a continuation sheet. The form asks about the business, not about any Veteran.
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What's on VA Form VA2793
Items 6 to 11: experience and references
Years in the artificial limb business here and elsewhere, whether the shop makes its own set-ups or its principal supplier, the physician's prescription practice for civilian amputees, business references for firms under 3 years old and referring civilian physicians.
Items 12 to 16: staff
Total employees, those engaged in fabrication, full-time qualified limb fitters, prosthetists who completed post-graduate prosthetics courses, and certified suction socket fitters with certificate numbers.
Items 17 to 25: premises
Whether the shop is in a private residence, office building or other, whether the fitting room is on the ground floor or elevators are available, floor space in square feet, and whether there are parallel bars, full-length mirrors and ramps.
Item 26: shop equipment
The number and type of each listed tool, from band saw, sanding disc and lathe to sewing machine, welding equipment and alignment jig, plus other equipment.
Certification and continuation sheet
A certification signed with title and date at the bottom of page 1, and a page 2 continuation sheet for fields too small to hold the text.
How to complete VA Form VA2793
- 1
Prepare one sheet per shop
The form asks for it in duplicate for each shop owned and operated by the bidder and for each branch or agent shop where service will be performed.
- 2
Enter the shop details
Fill in Items 1 to 5 with the bidder, shop name, address, trade name and business days and hours.
- 3
Add experience and references if needed
Complete Items 6 to 11 unless the firm has previously held a VA contract and nothing has changed.
- 4
Describe staff, premises and equipment
Complete Items 12 to 26. Where the form asks about post-graduate courses or suction socket fitters, it says to write none if there are none.
- 5
Sign the certification
Sign with your title and the date. If space is not sufficient, the form says to continue on a separate sheet of paper and attach it, or use the page 2 continuation sheet.
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Submitting it and edition details
Who submits it
The bidder submits it as part of the bidding process, in duplicate for each shop. The form prints no mailing address.
Disclosure
The form says the information is solicited under Title 38, disclosure is voluntary, and failure to furnish it will result in delaying the bidding process.
Edition
The form is dated MAR 2002(RS), and VA's form page lists a revision date of March 2002 under VACO.
Related forms
Who uses VA Form VA2793?
The note at the top of the form says who completes it and what VA does with it.
Official sources and the blank
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Questions about Form VA2793
Who fills out VA Form VA2793?
The form says it is completed and submitted by the bidder, for each shop at which service will be performed under the contract, including branch shops and shops of the bidder's agents.
How many copies are needed?
The form asks for it in duplicate for each shop owned and operated by the bidder and for all branch shops and shops of the bidder's agents.
Does a firm with a past VA contract fill in every item?
The form says firms which have previously held contracts with the Department of Veterans Affairs do not need to fill out Item 6 through Item 11, unless changes have occurred.
Is giving this information voluntary?
The form says disclosure is voluntary, but failure to furnish the information will result in delaying the bidding process, with no adverse effect on any other benefits.
What if an answer does not fit?
The form says to continue on a separate sheet of paper and attach it. Page 2 is a continuation sheet for fields too small to hold the text.