letter, which is a complete listing of VA medical facilities
r

and telephone numbers.

Enclosures 2-4 are a postage-paid envelope,
FORM

a QUICK-RETURN

(to tell us whether you want a medical examination),

and a QUESTIONNAIRE

test participation).

(to provide us data on your nuclear

If you desire a medical examination,

please schedule an appointment with the nearest VA facility,
complete the QUICK-RETURN FORM, complete or update the
QUESTIONNAIRE, and return them to us
envelope as soon aS possible.

in the postage-paid

If you experience difficulty

in scheduling an appointment, please advise us so that we
can assist you.

Should you elect not have the medical examina-

tion performed,

this does not preclude your requesting an

examination at a later date, and we would appreciate your
returning the completed QUICK-RETURN FORM and QUESTIONNAIRE
for

our

records.

Enclosure 5 is a letter to the physician who will perform
the examination, and should be presented by you to the
examining physician at the time of your appointment.

The

attachment to the letter for the physician is a MEDICAL
HISTORY FORM.

You can save time and provide valuable assist-

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ance to the examining physician if you use the MEDICAL

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