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). If so, please list the area.
Did you receive any specialty badges? (e.g., Parachutist, Air Assault, Combat Action Ribbon)
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