Get Nhpco Whv Military History Checklist 2012-2025

The NHPCO WHV Military History Checklist is an essential document designed to gather important information about a person's military history and VA benefits. This guide will walk you through the process of completing the form online, ensuring that users can submit accurate and comprehensive information.

Follow the steps to complete the NHPCO WHV Military History Checklist.

1. Click ‘Get Form’ button to obtain the form and open it in the document editor.
2. Begin by filling out the patient data section. Provide your name, address, date, hospice medical record number, and the last four digits of your Social Security number.
3. Move to the veteran status information section. Indicate whether you, your spouse, or a family member served in the military. Answer the questions regarding active duty, combat service, and the availability of DD214 discharge papers by selecting 'Yes' or 'No.'
4. Continue by entering military background details. Select the branch of military you served in from the provided options. Specify the war era or period of service you were involved with.
5. In the military experience field, provide your overall view of your military experience. Indicate if you would prefer your hospice staff or volunteer to have military experience.
6. Proceed to the VA benefits information section. Provide information on whether you are enrolled in the VA, if you receive VA benefits, and if you have a service-connected condition.
7. Complete the final questions regarding your medication sources and the name of your VA hospital or clinic, along with your VA physician or primary care provider's contact information. Conclude by indicating if you would like to discuss potential benefits you or your family may be eligible for.
8. Once you have filled out all required sections, review your entries for accuracy. Save your changes, and choose to download, print, or share the completed form as needed.

Start filling out the NHPCO WHV Military History Checklist online today to ensure your information is accurately captured.