Alcohol Questionnaire - Dependant

Form ID
D1215
Audience
General

This form is in connection with a claim for pension and medical treatment, and assist in deciding eligibility for benefits under the Veterans’ Entitlements Act 1986 and/or Military Rehabilitation and Compensation Act 2004.

If you are using an Apple computer and want to fill out your form electronically, please download the form and open it with Acrobat 7 or later.

How can I access this form?
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Form (PDF or Word)