Let us know about your military service

You can use this form to let us know that you are a former member of the British Armed Forces.

Anyone who served for one day is classed as a Veteran and is entitled to the same level of specialist support and care.

Visit our Veterans page for more information.

We may need to contact you to confirm details of your service, including your medical summary. Please make sure to add a current phone number or email address for us to get in touch.

About You

Name(Required)

First Last

Date of Birth(Required)

Address(Required)

Street Address Address Line 2 City ZIP / Postal Code

Phone

Your Service

When did you leave the Armed Forces?(Required)

Do you have your medical summary form (FMed133A)?(Required)

Yes

You can upload a copy of your Certificate of Release or Discharge from Active Duty (DD214) here.

Drop files here or

Max. file size: 5 MB.

Do you have your Certificate of Release or Discharge from Active Duty (DD214)?(Required)

Yes

You can upload a copy of your medical summary form (FMed133A) here.

Drop files here or

Max. file size: 5 MB.

Is there anything else you want to tell us about your military service that will help us give you the best possible care?

For example, you might want to tell us which branch of the Armed Forces you served in or any conditions or issues relevant to your care. All information you provide is confidential.

Name

This field is for validation purposes and should be left unchanged.