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The document is a Breast & Cervical Cancer Treatment Program Eligibility, Release and Consent Form from the Spokane Regional Health District. It collects personal information for eligibility screening, including details about income, health insurance, residency, and consent for medical record sharing. The form is intended for individuals seeking medical coverage for breast or cervical cancer treatment through the Washington State Health Care Authority.

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2016	4.8 Satisfied (155 Votes)
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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Are you still a veteran with an honorable discharge?

Under federal law a veteran is any person who served honorably on active duty in the armed forces of the United States. Discharges marked General and under honorable conditions also qualify.

How do I know if my discharge is honorable?

To receive an honorable discharge, a service member must have received a rating from good to excellent for their service. Service members who meet or exceed the required standards of duty performance and personal conduct, and who complete their tours of duty, normally receive honorable discharges.

Does DD-214 say honorable discharge?

The DD214 is issued by The Department of Defense to every veteran; your record will include important information, including your discharge status: Honorable, General Other Than Honorable (GOTH), Other Than Honorable (OTH), Dishonorable, or Bad Conduct.

How do I get a 214 form?

If you need assistance obtaining your military records, then contact any County Veteran Service Officer (CVSO). To obtain your DD-214 on your own, submit your request via the National Archives and Records Administration webpage or call 314-801-0800.

Where can I get a blank DD-214 form?

You can request a copy of your DD214 and other military service records from the National Archives.

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How do you get a DD-214 PDF?

There are two ways you can obtain a copy of your DD-214. The first is to use ebenefits and the second is to submit a written request through the National Archives. You will be notified by email when your documents are ready.

Does a DD-214 show honorable discharge?

The purpose of recording the Veterans Honorable Discharge (DD214) is to secure the record of the honorable discharge of the soldier, sailor, marine, or nurse who has served in the the United States Army, Navy, Marines, Air Corp, or Coast Guard for future access for benefits of the veteran or survivor.

Where can I see my discharge status on my DD-214?

Note: Sections 23-30, Character of Discharge, can only be found on long form or undeleted copies of the DD214. Service 2 copy and Member 4 copy are the long-form copies. 23. Type of Separation: Discharge, administrative separation or other types are listed here.

214 cervical form fillable 2025

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Are you still a veteran with an honorable discharge?

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