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VA Death Certificate Input Request

  1. Input on VA issues

    The board’s goal is to gather information for legislators and senators that shows them how citizens are being affected. We are seeking out individuals who are having issues related to being unable to obtain death certificates from the Veterans Affairs (VA) doctors upon the death of a military member in your family.

  2. Reporting Party Information
  3. I understand that by submitting this form I am volunteering my information to be shared with legislators. I recognize this is not an immediate remedy to the situation, but simply a way to give input on it. *
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