Client Intake

Valor Medical Reviews

Client Intake
Are you a veteran?
Do you have an injury thought to be related to your time in service?
What type of injury are you filing for?

Other

Section 1: Case Information
1. Full Legal Name
2. Date of Birth

MonthDayYear
3. Preferred Contact Email
4. Type of Nexus Letter Requested

Other
5. Condition or Injury Being Reviewed

Section 2: Injury / Condition Summary
6. Brief Summary of Military Service Connection
7. Is This Condition:
8. Has the VA Previously Issued a Decision for This Condition?

Section 3: Supporting Documentation Statement

Important: Nexus opinions are strongest when supported by service and medical documentation.

Please review and acknowledge the following statement:

I understand that service treatment records, VA medical records, private medical records, and personal statements significantly strengthen a medical nexus opinion. I acknowledge that submitting relevant records improves the quality and defensibility of the review.
9. Records Acknowledgment

Section 4: Record Upload (HIPAA – Secure Submission)

Please upload records using the secure link below. Do not email medical records.

We encourage submission of:
- Service treatment records
- VA decision letters
- VA or private medical records
- DBQs (if applicable)
- Personal statements or buddy statements
10. Upload Supporting Documentation (This can be provided later if preferred, but submitting here allows for faster case evaluation)

Cancelof

Final Acknowledgment

I certify that the information provided is accurate to the best of my knowledge and understand that Valor Independent Medical Reviews, LLC provides independent, conflict-free medical opinions and does not guarantee VA outcomes.
11. Consent & Attestation
Should be Empty: