To learn if a veterans benefits advisor/planner would be beneficial to your situation and to be connected with one who meets your needs, please answer the following questions.

  1. What is your relationship to the veteran?*
    Please select your relationship to the veterans from the menu.
  2. What is the current status of your claim?*
    Please select your claim status.
  3. For what type of claim are you seeking assistance. Choose all that apply.*

    Please select at least one.
  4. How much care does the applicant currently require?*
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  5. What type of assistance is the applicant seeking?*
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  6. What is the veteran’s marital status?*
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  7. What is the approximate income of the veteran and / or their spouse? Do not include income from the VA.*
    Please select an approximate monthly income.
  8. What is the approximate value of the veteran's assets, not including their home?*
  9. Did the veteran serve during wartime?*
    Please select an answer from the menu.
  10. In what state does the veteran reside?*
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  11. Enter your full name*
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  12. Please enter your email address*
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  13. Please enter your phone number*
    Please enter a valid 10-digit phone number.

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