Participant claim form 2026

1. Click ‘Get Form’ to open the participant claim form in the editor.
2. Begin with Part 1, where you will enter your personal information including your first name, last name, and Social Security number. Ensure all details are accurate to avoid processing delays.
3. If applicable, indicate your membership in an Indian Tribe by checking the relevant box and providing your census number.
4. Proceed to Part 2 if you are not the person who became ill. Fill in the claimant's details as required.
5. In Part 3, specify your relationship to the individual who became ill. Follow the directions based on your relationship type.
6. Complete Parts 4 through 7 based on whether you are a self-filer, surviving spouse, child, or other eligible relative. Provide necessary documentation as specified.
7. In Part 8, provide information regarding onsite participation of the person who became ill. Include dates and locations of participation.
8. Finally, review all sections for completeness and accuracy before signing at Part 15. Submit your completed form via mail as instructed.

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