The Region 4 (Southwest) Regional VOAD includes the localities of:
- Bland County
- Bristol City
- Buchanan County
- Carroll County
- Dickenson County
- Galax City
- Giles County
- Grayson County
- Lee County
- Norton City
- Pulaski County
- Radford City
- Russell County
- Scott County
- Smyth County
- Tazewell County
- Washington County
- Wise County
- Wythe County