Nexus Letter

First Name

Last Name

Phone Number

Date of Birth

Do you have time constraints or deadlines for submitting your Nexus letter?

Yes

What is the estimate deadline for submitting your Nexus letter?

Do you have a C-File?

Yes

I don't know

Est. page count of your C-File

Provide a brief summary of your case or claim and describe the injury or health issue(s), disease and/or condition(s) related to service and the sequence of events in the order that they occurred, with dates if possible (500 character limit)

Do you have an attorney representing you on your case?

Yes

City and State of your case

City

State

Branch of Military Service

Approximate Date of Start of Service

Approximate Date of End of Service

I have read and agree to the Terms and Conditions and Privacy Policy

Thank you for your interest in a Nexus Letter. Once we receive your information, we will review the details and contact you for what we believe are the next steps.

Nexus Letter

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