How to Fill Out and Mail VA Form 1107: Repairs and Accessories

VA Form 1107, the Request for Repairs and/or Accessories, is how a veteran gets a VA-issued hearing aid fixed or orders replacement parts like tubing, cords, and wax guards. You fill it out, pack it with the defective device if you need a repair, and mail everything postage-free to the VA Denver Logistics Center in Colorado. The service costs nothing as long as you remain eligible for VA health care, and repairs typically take about 20 days from the day Denver receives your package.¹

Who Can Use the Form

Any veteran enrolled in VA health care who was issued a hearing aid through the VA can use Form 1107. A service-connected hearing loss rating is not required; VA practice is that any enrolled, eligible veteran qualifies for hearing aids and, by extension, free repairs and accessories.² The device does have to be one the VA authorized and issued to you. A hearing aid bought privately from an outside audiologist is not covered by this form.³

Getting the Form

You can download Form 1107 as a PDF from VA.gov.⁴ If you call the Denver Logistics Center and request a shipping kit, a blank form comes inside the box along with a protective bag for the hearing aid and a postage-paid return label.¹ The form itself is a single card: a top section for your details and the device, and two sections on the reverse, one for repairs and one for accessories.

Filling Out the Top Section

Complete every field:

Full name (last, first, middle initial)
Date of birth in MM/DD/YYYY format
Last four digits of your Social Security number
The date you are mailing the package
The home mailing address where you want the device or parts returned
The make, model, and serial number of the hearing aid

The make, model, and serial number are usually printed on the device or on its original packaging. If the print has worn off, your local VA audiology clinic can look the information up for you.

Section I: Repairs

If your hearing aid is malfunctioning, check every box in Section I that describes what is wrong. The listed defect options are: dead, fades, intermittent, moisture damage, telecoil dead or weak, noisy, weak, distorted, excessive battery drain, and feedback.

Check as many as apply. If the device cuts out during phone calls and also chews through batteries, mark both intermittent and excessive battery drain. Detail helps the technicians diagnose faster.

Section II: Accessories

If you only need parts, skip Section I and use Section II. Write the items you need in the space provided, with any relevant details. For cords or straight tubing, include the length. The VA supplies cords, tubing, wax guards, ear hooks, domes, cleaning supplies, and desiccant drying products through this process.⁵ Use the Remarks field for anything unusual or not on the form.

What Goes in the Package

What you send depends on the request.

For a repair, include the hearing aid, the completed form, and every part you normally use with the device. A body aid means the aid, cord, and receiver. A receiver-in-the-canal device means the behind-the-ear piece and the receiver that sits in the ear.

For an accessory order alone, send just the form. Your hearing aid stays home. If you are replacing defective cords or tubing, include the old ones so the technicians can match the replacement.

Do not send your presentation case. The shipping box and packing material protect the device on their own, and adding the case slows processing.¹

Packing and Shipping

Use a sturdy box with padding. Never mail a hearing aid in an envelope; it will be crushed. If you do not have a suitable box, call the Denver Logistics Center for a free shipping kit.¹

The form itself carries a postage-free mailing label. Attach it to your package and drop it at any U.S. Post Office. You pay nothing for shipping.

Where to Mail It

Send everything to:

VA Denver Logistics Center
PO Box 25166
Denver, CO 80225-0166¹

This is the only address for Form 1107. Local audiology clinics handle some issues in person, but all mail-in repairs go through Denver.

Turnaround and What Comes Back

The Denver Logistics Center typically completes repairs within 20 days of receiving the package.⁶ The device returns in a reusable shipping box; keep it for the next repair.

If the hearing aid cannot be repaired, the process shifts to a replacement. Contact the VA Audiology and Speech Pathology Service that issued the original device to schedule a fitting appointment for a new one.

Ear Molds

You can mail ear molds to Denver for cleaning or retubing, but only if the mold is fully integrated, meaning the receiver-in-the-canal receiver sits inside the mold and cannot be removed. A non-integrated mold should not be mailed in; contact your local VA audiology clinic for a replacement instead.¹

When to Skip the Form and Go to the Clinic

Form 1107 covers physical repairs and parts. Some situations are better handled by the clinic that issued the device:

The hearing aid needs a fitting or programming adjustment rather than a physical repair.
You need a non-integrated ear mold replaced.
The device is lost or damaged beyond repair and you need a full replacement.
You cannot identify the make, model, or serial number and need help looking it up.

The VA also directs any questions about the form itself to the Audiology and Speech Pathology Service that issued your hearing aid. That office can walk you through the form, help identify the right accessory to order, and tell you whether Denver or the local clinic is the better route.¹

1
Veterans Affairs. Request Hearing Aid Repairs and Accessories
2
U.S. Department of Veterans Affairs. VA Hearing Aids Fact Sheet
3
U.S. Department of Veterans Affairs. VA Hearing Aids – Rehabilitation and Prosthetic Services
4
U.S. Department of Veterans Affairs. VA Form 1107 – Request for Repairs and/or Accessories
5
Veterans Affairs. Order Medical Supplies
6
U.S. Department of Veterans Affairs. Denver Logistics Service