Va Form 119 PDF Details

Engaging with veterans and understanding their needs is a crucial part of providing them with the support and services they deserve. The VA 119 form, known as the Report of Contact Note, plays a pivotal role in this process by documenting interactions between veterans and the Department of Veterans Affairs (VA). This form, which should always be filled out in ink to ensure its permanence in the veteran’s folder, captures vital details such as the veteran's name, the date of interaction, and contact information. It distinguishes between types of contacts—whether personal or over the phone—and requires information about both the individual who initiated the contact and the VA representative involved. What stands out about the VA 119 form is its section for a brief statement where details of the information requested and provided are recorded, ensuring clarity and accountability in communications. It’s specifically designed to facilitate clear, documented communication, highlighting the VA's commitment to responsiveness and tailored support for veterans. Moreover, the insistence on not using pencil underscores the importance of maintaining a permanent, unalterable record of these interactions. This form is a critical tool in the ongoing effort to serve veterans efficiently and with the respect they deserve.

QuestionAnswer
Form NameVa Form 119
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesva report of contact 119, report of contact va form, va report of contact, va form report of contact

Form Preview Example

REPORT OF CONTACT

NOTE: As appropriate, once this form is completed it becomes a permanent record in the veteran's folder. Please do not use a pencil to complete this form.

VA OFFICE

IDENTIFICATION NOS. (C,XC, SS, XSS, V, K, etc.)

LAST NAME-FIRST NAME-MIDDLE NAME OF VETERAN (Type or print)

DATE OF CONTACT

 

 

 

ADDRESS OF VETERAN

TELEPHONE NO. OF VETERAN (Include Area Code)

 

 

PERSON CONTACTED

TYPE OF CONTACT (check one)

 

PERSONAL

TELEPHONE

 

 

ADDRESS OF PERSON CONTACTED

TELEPHONE NO. OF PERSON CONTACTED

 

(Include Area Code)

 

 

 

PERSON WHO CONTACTED YOU

TYPE OF CONTACT (check one)

 

PERSONAL

TELEPHONE

 

 

ADDRESS OF PERSON WHO CONTACTED YOU

TELEPHONE NO. OF PERSON WHO

 

CONTACTED YOU (Include area code)

 

 

 

BRIEF STATEMENT OF INFORMATION REQUESTED AND GIVEN (Continue on page 2 if needed)

 

 

DIVISION OR SECTION

VA FORM

119

SEP 1997 (R)

EXECUTED BY (Signature and title)

BRIEF STATEMENT OF INFORMATION REQUESTED AND GIVEN

VA FORM 119, SEP 1997 (R), PAGE 2

How to Edit Va Form 119 Online for Free

It is easy to fill out the report of contact empty blanks. Our PDF tool makes it practically effortless to prepare any specific PDF. Listed below are the only four steps you need to follow:

Step 1: Get the button "Get Form Here" and hit it.

Step 2: Once you get into our report of contact editing page, there'll be all of the functions you can undertake with regards to your document at the upper menu.

Fill in all of the following areas to fill out the document:

va report of contact blanks to complete

Write down the requested details in the field DIVISION OR SECTION, EXECUTED BY Signature and title, and VA FORM SEP R.

Finishing va report of contact step 2

The software will demand for additional info as a way to automatically prepare the section BRIEF STATEMENT OF INFORMATION.

stage 3 to entering details in va report of contact

Step 3: Select the "Done" button. Now, you may export your PDF document - download it to your electronic device or send it by means of email.

Step 4: To protect yourself from any specific headaches down the road, you should have around several duplicates of the file.

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