It may come to pass that the below form will supplant the above. It already appears as though that is the way things are heading. Notice that this form leaves no room for a nexus tying the disease process to active duty in the military? That it doesn’t even ask for one? Perhaps the VA feels this important item is more in their purview.
asknod
brewerkelli
cspencer02
jamesaurora
kcraveiro
Laura
Veterans Claims Help 
This form is stupid. It’s also a “trick and trap” form. Can they be more specific? Ex. #3. High-risk sex. Do you mean men having sex with men? Which acts have you identified as casual for HCV? Do you mean having unprotected sex with partner trying to conceive a child? # 9. So only health care workers can answer this question? As if healthcare workers have magical ESP-like powers to detect contaminated blood in emergency situations! What about the soldier giving first aid to another injured and bloody soldier in the field? That doesn’t qualify?
Make your own form and attach it as an addendum.
Example: 1. Have;you ever been vaccinated with an old generation needless, multi-dose jet injector also known as MUNJIs? If so, where and when? (My DH–dear husband–has a MUNJI photo in his 1969 Paris Island boot camp photo book. Lost yours? Military librarians/historians probably have one on the shelves for your branch. They can find the photo–if it hasn’t been cut out–and will send you a photo copy and your photograph too.)
Is this a relevant question? YES. It should be #1 on the list. As the worlds’ governmental public health professionals say now “ONE NEEDLE, ONE SYRINGE, ONLY ONE TIME.” (www.oneandonly.org) Poster downloads in pdf available. This is the only known way to prevent cross-contamination infections between patients. No other injection medical devices/practices have been proven 100% safe.