10066 form 2026

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The document is a draft of the Open Burn Pit Registry Airborne Hazard Self-Assessment Questionnaire, created by the VA to collect information from veterans regarding their deployment history, health symptoms, and exposures to airborne hazards during military service. It aims to improve service delivery and health care for veterans by understanding their experiences with environmental exposures, health conditions, and utilization of health care services. The questionnaire includes sections on deployment history, medical history, symptoms, non-military work history, and preferences for communication.

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Click ‘Get Form’ to open the 10066 form in the editor.
Begin by filling out your Deployment History. Enter your deployment dates and locations as prompted, ensuring accuracy for each entry.
Proceed to the Symptoms and Medical History section. Here, you will detail any health conditions or symptoms experienced during or after deployment.
In the Health Concerns section, indicate any specific health issues you believe are related to your deployment exposures. This helps in tailoring support services.
Complete the Residential History and Non-Military Work History sections by providing addresses and job details that may relate to environmental exposures.
Review all entries for accuracy before submitting. Use our platform's editing tools to make any necessary adjustments easily.

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