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Preliminary independent living assessment 2026

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The document is a VA form (OMB Control No. 2900-0681) designed for conducting a Preliminary Independent Living (IL) Assessment for veterans. It includes a questionnaire that evaluates the veteran's ability to perform Activities of Daily Living, assesses potential alcohol/substance abuse issues, housing conditions, personal and emotional needs, and leisure activities. The responses will help determine the level of support needed for the veteran's independent living.

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Click ‘Get Form’ to open the preliminary independent living assessment in the editor.
Begin by entering your personal information at the top of the form, including your first, middle, and last name, VA file number, social security number, and date.
Proceed to Part I - Activities of Daily Living. For each task listed, indicate the level of difficulty you experienced in the past month by checking the appropriate box.
Continue through Parts II to VI, answering questions regarding alcohol/substance abuse, housing situation, personal/emotional needs, leisure activities, and any additional comments as necessary.
Review all your responses for accuracy before saving or submitting the completed form.

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