Act of 1974.

Your cooperation in this important health

study will be appreciated.

Sincerely,

6 Enclosures
l. Locations, VA
hm GO)

2.
»-

Medical Facilities
Return Envelope

QUICK-RETURN FORM
QUESTIONNAIRE (Nuclear

Test Participation)
5. Letter to Examining
Physician
6. VA Claims

APPROPRIATE SIGNATURE

Sponsoring Military Department
(NTPR Team Chief)
(Surgeon General or Assistant)

Select target paragraph3