Va form 21 0960p 3 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient/veteran's name and Social Security number at the top of the form. This information is crucial for identification purposes.
3. In Section I, answer whether the veteran has been diagnosed with PTSD. If 'Yes', proceed to complete the questionnaire; if 'No', follow instructions for other diagnoses.
4. Move to Section II and list current diagnoses along with their ICD codes. Ensure you categorize each diagnosis under Axis I or II as required.
5. In Section IV, summarize the veteran's level of occupational and social impairment by selecting one option that best describes their condition.
6. Complete Section VI by checking all applicable PTSD diagnostic criteria based on your assessment of the veteran's symptoms.
7. Finally, ensure that a psychiatrist or psychologist certifies and signs the form in Section XI before submission.

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