New Client Onboarding Form
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Primary Email
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First Name
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Last Name
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Primary Phone
Are you receiving VA compensation for a disability?
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No
Yes
What type of discharge did you receive?
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Honorable
General
Other Than Honorable (OTH)
Bad Conduct
Did you serve in a combat area or areas considered hostile for VA Purposes? (e.g., Vietnam, Bosnia, Gulf War, Somalia)
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Yes
No
Did you receive any specialty badges? (e.g., Parachutist, Air Assault, Combat Action Ribbon)
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Yes
No
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