Veterans Benefits Liability Waiver Form

Veterans Benefits Liability Waiver Form
Please complete this form to acknowledge your understanding and acceptance of the liability waiver for veterans benefits assistance services.
Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Mailing Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Are you a U.S. military veteran?
Branch of Service
Years of Service
Which veterans benefits assistance service are you seeking?
Please specify any additional information or questions (optional)
Liability Waiver and Acknowledgment

I acknowledge that I am voluntarily requesting assistance with veterans benefits through this program. I understand that the assistance provided is for informational and support purposes only, and does not constitute legal, medical, or financial advice. I release the program, its staff, and volunteers from any liability for decisions or actions I take based on the information or support provided. I confirm that I have not provided any sensitive personal or financial information. By signing below, I acknowledge and accept the terms of this waiver.
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