This intake form helps prepare your Veteran Benefits Action Plan. Valor Veteran Benefits provides educational and organizational guidance only and does not file claims or provide legal representation.

Years of Service (start-end)

Type of Service

Active Duty

Deployments (if applicable)

Type of Discharge

Honorable

General (Under Honorable Conditions)

Other Than Honorable

Have you ever filed a VA claim before?

Yes

If you have already filed what is your current VA rating?

List any conditions you have already claimed or have been rated for (if any)

Have you ever received a VA denial

Yes

If yes or not sure, what was denied or what are you unsure about?

Medical Conditions & Symptoms

List any diagnosed or ongoing medical or mental health conditions you believe may be related to your service (you do not need perfect wording -just list what you experience)

For each condition listed above, describe your current symptoms and how they affect your daily life or ability to work (Examples: pain, sleep issues, mobility limits, concentration, missed work, etc. )

Do you currently receive treatment for any of these conditions?

What records do you currently have access to?

Service Treatment Records

Private Medical Records

Prior VA Decision Letters

What documentation feels missing or hard to obtain right now?

What is your biggest question or concern about the VA benefits process right now?

What are you hoping to get out of your Veteran Benefits Action Plan?

Clarity on where to start

Preparing before filing

Understanding a denial

Understanding ratings

C&P exam preparation

I understand Valor Veteran Benefits is not a law firm and is not affiliated with the Department of Veterans Affairs. I understand they do not provide legal advice, do not file claims on my behalf, and do not represent me before the VA.

I acknowledge and agree

Yes, I understand and agree

Valor Veteran Benefits – Intake Form

Full Name

Email

State of Residence

Branch of Service