VA Form 10-0491I: HPSP & VIOMPSP Notice of Change

VA Form 10-0491I: HPSP & VIOMPSP Notice of Change – VA Form 10-0491I is a critical document for recipients of the VA Health Professional Scholarship Program (HPSP) and the Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP). This form helps scholarship participants report changes in their academic or personal information and submit required annual academic status updates to maintain eligibility and good standing.

What Is VA Form 10-0491I?

VA Form 10-0491I, titled Notice of Change and/or Annual Academic Status, serves recipients of the Health Professional Scholarship Program (HPSP), Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP), and related programs like VHVMAESP.

Participants must submit this form for:

  • Any changes from the original application (e.g., name, address, enrollment status, academic standing, graduation date).
  • Annual verification of academic status, including transcripts or grade reports.

The form is fillable and available as a PDF from the official VA website.

Purpose of VA Form 10-0491I in HPSP and VIOMPSP

The HPSP and VIOMPSP provide financial support (tuition, fees, stipend) to students in qualifying health professions in exchange for a service obligation at a VA facility after graduation. Maintaining accurate records through Form 10-0491I ensures continued scholarship funding and compliance with program rules.

Key requirements include full-time enrollment, satisfactory academic progress (typically a minimum CGPA), and timely notification of changes. Failure to submit required notices or annual updates can jeopardize the scholarship award.

Who Must Use VA Form 10-0491I?

  • Current HPSP scholarship recipients pursuing degrees in fields like medicine, nursing, psychology, social work, and other health professions.
  • VIOMPSP recipients in programs for visual impairment, orientation and mobility, low vision therapy, or related blind rehabilitation specialties.
  • Participants needing to report changes or provide annual academic verification.

Both U.S. citizens (by birth or naturalization) enrolled in accredited U.S. programs typically qualify, with specific eligibility varying by program.

Key Sections and Information on VA Form 10-0491I

The form includes checkboxes and fields for:

  • Annual Status/Progress Report — Confirm ongoing enrollment with no changes and attach current transcript.
  • Notice of Change — Report updates such as name/address changes, completion date adjustments, course changes, credit hour changes, school/program changes (requires prior approval), academic probation, dismissal, leave of absence, or changes in projected costs.
  • Advisor certification and signature for certain academic changes.
  • Supporting documentation requirements.

Submit the completed form to: HPSP/VIOMPSP/VHVMAESP, Department of Veterans Affairs, 1250 Poydras St., Suite 1000, New Orleans, LA 70113.

How to Complete and Submit VA Form 10-0491I?

  1. Download the official fillable PDF.
  2. Select HPSP, VIOMPSP, or both as applicable.
  3. Provide your personal details (name, SSN last 4 digits, contact info).
  4. Indicate the type of submission (annual status or specific changes).
  5. Attach required documents (transcripts, fee schedules, etc.).
  6. Obtain academic advisor signature where needed.
  7. Sign and date the form.
  8. Mail or follow program-specific submission instructions (monthly check-ins may be required via the Application Management System for some recipients).

Download VA Form 10-0491I here: VA Form 10-0491I PDF

Always use the most current version from VA.gov for compliance.

Why Timely Submission Matters for Scholarship Recipients?

Monthly or periodic check-ins and annual reports help VA track your progress. Changes in enrollment status, academic standing, or personal information must often be reported within 10 days. Prompt use of Form 10-0491I prevents interruptions in stipend payments and protects your service obligation status.

  • VA Form 10-0491 (Academic Verification)
  • Other program-specific forms for graduation notices, deferments, and service obligation placement.

For full program details, visit the official VA Careers scholarship page or contact the HPSP Team at [email protected].

Tips for HPSP and VIOMPSP Success

  • Maintain full-time enrollment and a strong GPA.
  • Keep your contact information updated.
  • Plan ahead for any program or school changes, as they may require prior approval.
  • Retain copies of all submissions and correspondence with VA.

This form is part of your commitment to serving Veterans through VA employment after completing your studies.

Information based on official VA sources as of 2026. Always verify the latest requirements directly on VA.gov, as forms and policies can be updated.