Va form 21 0960q 1 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's name and Social Security number at the top of the form. This information is crucial for identification purposes.
3. In Section I, indicate whether the veteran has been diagnosed with Chronic Fatigue Syndrome (CFS) by selecting 'Yes' or 'No.' If 'Yes,' complete Item 1B by checking all applicable conditions and providing ICD codes and dates of diagnosis.
4. Proceed to Section II, where you will indicate which medical records were reviewed in preparation for this report. Select from options like C-FILE or provide a brief description of other records.
5. In Section III, summarize the veteran's medical history related to CFS. Answer questions regarding medication requirements and whether other conditions have been excluded.
6. Continue through Sections IV to IX, providing detailed responses about symptoms, functional impact, and physician certification as required.

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