Response

Veterans Impacts

This form is for veterans and their communities to share information with the office of U.S. Senator Tammy Duckworth, regarding any impacts the current Administration has had on their ability to access their care and benefits.

Other

Contact Information

Prefix

First Name

Last Name

Address Line 1

Address Line 2

City

State

Zip

Cell Phone

Tell us about you...

Please select at least one of the following: Veteran
Family member or friend of a veteran
Family member or friend of a servicemember (ex. military spouse)
Current National Guardsman or Reservist
Active duty
Prefer not to say

Other

What is the general topic(s) of your message? Select up to three of the below that apply to the information you would like to share with the Committee. Appointment Scheduling
Claims Examination
Claims Backlog
Quality of Care
Community Care

Other

Please write the information you would like to share here.

Attach copies of any relevant documents or notices here. Allowed file types include .doc, .docx, .jpeg, .pdf, or .txt. Total file size limit is 15MB.

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How did you hear about this form? Optional. We would appreciate knowing how you found this form. Did someone you know send it to you? Did you find it on social media? etc.

By selecting "yes" below and submitting this form, you confirm that the information you have shared here is to the best of your knowledge.