United States Department of Veterans Affairs
Office of Academic Affiliations

Military Health History Pocket Card for Clinicians

Ask these questions of military service members and all Veterans:

  ?      General Questions

  • Tell me about your military experience.
  • When and where do you / did you serve?
  • What do you / did you do while in the service?
  • How has military service affected you?

 If your patient answers "Yes" to any of the following, ask:
"Can you tell me more about that?"

  • Did you see combat, enemy fire, or casualties?
  • Were you or a buddy wounded, injured or hospitalized?
  • Did you ever become ill while you were in the service?
  • Were you a prisoner of war?

  ?       Compensation and Benefits

  • Do you have a service-connected condition?
  • Would you like assistance in filing for compensation for injuries/illnesses related to your service?

    ("Call VBA at 1-800-827-1000")

  ?      Hepatitis C Virus (HCV) Infection

  • Did you have a blood transfusion?
  • Have you ever injected drugs such as heroin or cocaine?

  ?      Living Situation

  • Where do you live?
  • Is your housing safe?
  • Are you in any danger of losing your housing?
  • Do you need assistance in caring for dependents?

  ?      Sexual Harassment, Assault and Trauma

  • Have you ever experienced physical, emotional, or sexual harassment or trauma?
  • Is this experience causing you problems now?
  • Do you want a referral?

  ?      Stress Reactions / Adjustment Problems

In your life, have you ever had an experience so frightening, horrible, or upsetting that, in the past month, you…

  • Have had nightmares about it or thought about it when you did not want to?
  • Tried hard not to think about it or went out of your way to avoid situations that reminded you of it?
  • Were constantly on guard, watchful, or easily startled?
  • Felt numb or detached from others, activities, or your surroundings?