VA Form 0928c, NATIONAL VETERANS SUMMER SPORTS CLINIC: Fill out & sign online

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Click ‘Get Form’ to open the VA Form 0928c in the editor.
Begin by entering the patient's name and last four digits of their Social Security number at the top of the form. Ensure this information is accurate for proper identification.
Fill in the patient's contact details, including daytime and cell phone numbers, as well as the VAMC where they receive care. This helps maintain communication.
Complete the medical history section by providing details about primary disabilities or diagnoses, including any spinal cord injuries or amputations. Be thorough to ensure a comprehensive assessment.
Attach necessary documents such as recent EKGs for patients over 40, a list of current medications, and any relevant discharge summaries. Use our platform's upload feature for convenience.
Finally, have the examining clinician sign and print their name at the bottom of the form, ensuring all sections are filled out completely before submission.

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