Intake Form

***DISCLIAMER - PLEASE READ***

WE ASK FOR YOUR E-BENEFITS INFORMATION TO ALLOW US TO QUICKLY SUBMIT CLAIMS, UPLOAD SUPPORITNG EVIDENCE/DOCUMENTS, AND COMMUNICATE FASTER WITH THE VA. THIS HELPS US SIMPLIFY THE PROCESS FOR YOU AND PROVIDE 100% ACCURATE STRATEGY AND RESULTS IN YOUR CLAIM.

IF YOU DON'T HAVE AN ACCOUNT YOU CAN CLICK HERE FOR HOW TO CREATE AN E-BENEFITS ACCOUNT

Deployed to Combat?

Yes

We will need your consent to log into your E-benefits account to analyze your claim, initiate an intent to file, and update representation. Do you consent to us doing this? *

Yes, I consent

No. I do not consent

Address

Seven Principles Corp 500 E Main Street Suite 1600 Norfolk VA 23503 | 866.937.7279 | [email protected]