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How to use or fill out VA Form 21-0960L-2 with our platform
- Click ‘Get Form’ to open it in the editor.
- Begin by entering the patient's name and Social Security number at the top of the form. This information is crucial for identification purposes.
- In Section I, indicate whether the veteran has sleep apnea by selecting 'Yes' or 'No.' If 'Yes,' provide details in Item 1B regarding the type of sleep apnea diagnosed, including ICD codes and dates.
- Proceed to Section II to describe the veteran's medical history related to their sleep disorder. Include any medications required for control and whether a breathing assistance device is used.
- In Section III, check any current findings or symptoms attributable to sleep apnea. Be thorough in documenting all relevant signs.
- Complete Section V by confirming if a sleep study has been performed and summarizing its results. This section is vital for validating the diagnosis.
- Finally, ensure that Sections VI and VII are filled out accurately, detailing any functional impacts of sleep apnea and providing remarks as necessary before signing in Section VIII.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2016 | 4 Satisfied (47 Votes) |
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