Valorithm Strategic Assessment

ReadinessScan™ Assessment
Section 1: Veteran & Condition Identification
First Name?*
Last Name?*
Email?*
example@example.com
Phone Number?*
Please enter a valid phone number.
Date of Birth?*

MonthDayYear
Date
State of Residence?*
Country of Current Physical Residence?*
Service Branch?*
Claim Type?*
Condition?*
Claim Condition situation?*

Pre-Service Aggravation: I had the condition before joining that worsened during service.Direct Service Connection: I believe my condition began during my time in the military.Secondary Service Connection: My new condition was caused or worsened by a condition I'm already rated for.Increased Rating: I am already rated for this condition, but it has gotten worse.Presumptive Condition: I was in a place or situation the VA recognizes as causing certain conditions (e.g., Gulf War, Burn Pit, Camp Lejeune)

Section 4: Nexus & Secondary Relationships
Do you believe your condition is linked to another service-connected condition?*

YesNo
Which primary condition do you believe it is linked to?
Explain why you believe these are related (in your own words).
Unanswered
Were you ever stationed in or deployed to a known PACT Act location?*

YesNo
If yes, select your deployment region*
Tour Start Date?

MonthDayYear
Presumptive condition related
Tour End Date?

MonthDayYear
Presumptive condition related
What is your military Separation/Discharge date?

MonthDayYear
Date

Section 5: Motivation & Goal-Setting
What is your main goal right now?
If you're a Veteran or Veteran Spouse, let us know if you would be interested in joining VetIntel Solutions as a Veteran Readiness Guide?

ReadinessScan™ Assessment