Apply for Residency
Forms for Admission
The following forms must be thoroughly and accurately completed for admission into the Iowa Veterans Home. Failure to complete the following forms may cause the admissions process to be delayed. Each local County Commission of Veterans Affairs Office is available for assistance in completing and submitting application for residency at the Iowa Veterans Home.
** Please submit your completed application along with supporting documents to the County Commission of Veteran Affairs Office in your county of residence. The application will not be processed until verification of Iowa residency is received from your County.
Locate your local County Commission of Veterans Affairs office here. - (This link opens in a new tab; it is maintained by the Iowa Department of Veterans Affairs.)
The links below will open in a new tab. The forms are in PDF format.
Choose the appropriate application packet to print:
OR-
Choose the individual form needed:
- Choose one of the following application forms
- Application Checklist
- Personal Functional Assessment
- Financial Affidavit
- Supplement To Application For Admission
- Release of Information
- Notification for Applicants
Please contact our admissions staff if you have any questions.
Jason Matteson
Admissions Coordinator
641-753-4325 or Jason.Matteson@ivh.state.ia.us
Kathy Kopsa
Admissions Supervisor
641-753-4514 or Kathy.Kopsa@ivh.state.ia.us