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Welcome to the VA´s Inquiry Routing & Information System! We are here to answer your questions.
Please complete the following details on your inquiry using the form below.

Please Select Inquiry Topic and Type

Screen Reader users press enter to select a Please Select a Topic. Please Select a Topic * Required

Route to State To ensure we route your submission to the proper office for reply,
please select the state where your regional office is located.

Medical Center List To ensure we route your submission to the proper office for reply,
please select the proper location (i.e. where you received care, or nearest facility):

Screen Reader users press enter to select a Select an Inquiry Type?. Select an Inquiry Type? * Required

--Inquiry Type Help

What is your Question for the VA?

Please ask your question or describe the issue in detail in the space below. If the question, or issue, is about a disability, please be specific as to the type of disability(ies) or the issue(s). If you have multiple claims for benefits pending and want the status, please tell us which claim this is about.

Please do not enter your name, file number, or social security number in the question box below. You will be asked this information in the sections below.

Question *

How does a Veteran relate to your Question?

I am asking about benefits/services: *

--Veteran Status Help

Are you the Dependant? Yes No

Your Relationship to Veteran

Is Veteran Deceased Yes No

Date of Death if known Press right arrow and then down arrow key to access tooltip (MM-DD-YYYY)

Preferred Response Type

By default, the VA will respond to you via email. However, if you would like to be contacted by a different method (telephone or US Mail), please select different Preferred Response Type below.

Preferred Response Type How Would You Like Us To Respond To Your Inquiry?

Your Contact Information

Since we have more than one million records in the IRIS system, it looks for an EXACT match of all identifying information, including your first name, last name, suffix, and email address. If you have submitted an inquiry previously, please be sure to enter your name and email address exactly as you did before to avoid problems finding your record.

Form of Address *

First Name *

MI If you have no middle initial, please leave blank

Middle Initial If you have no middle initial, please leave blank

Last Name * If your name includes a suffix such as Jr, Sr, IV, etc., please enter in separate Suffix field below.

Suffix Only if Applicable

Email Address * For security and privacy reasons, we use your email address as a primary identifier. If you have submitted an inquiry previously, please use the same email address you entered before.

Re-enter a value for the field 'Email Address' *

Daytime Phone

Country *

Street

City

State

Postal Code

Dependent Information

Relation to Veteran

Dependent Relation to Veteran

Form of Address

Dependent Form of Address

First Name

Dependent First Name

MI If the dependent has no middle initial, please leave blank.

Dependent Middle Initial If the dependent has no middle initial, please leave blank.

Last Name If last name includes a suffix such as Jr, Sr, IV, etc., please enter in separate Suffix field below.

Dependent Last Name If last name includes a suffix such as Jr, Sr, IV, etc., please enter in separate Suffix field below.

Suffix Only if Applicable

Dependent Suffix Only if Applicable

Email Address Email address, if any, must be different from the email addresses entered in section(s) above; otherwise, leave blank.

Although not required, providing the Dependent’s email address may reduce the time it takes to process your inquiry by helping us to match identifying information.

Dependent Email Address Email address, if any, must be different from the email addresses entered in section(s) above; otherwise, leave blank.

Re-enter a value for the field 'Dependent Email Address'

Daytime Phone

Dependent Daytime Phone

Country

Dependent Country

Street

Dependent Street

City

Dependent City

State

Dependent State

Postal Code

Veteran Information

Form of Address

Veteran Form of Address

First Name

Veteran First Name

MI If the veteran has no middle initial, please leave blank.

Veteran Middle Init If the veteran has no middle initial, please leave blank.

Last Name If last name includes a suffix such as Jr, Sr, IV, etc., please enter in separate Suffix field below.

Veteran Last Name If last name includes a suffix such as Jr, Sr, IV, etc., please enter in separate Suffix field below.

Suffix Only if Applicable

Veteran Suffix Only if Applicable

Email Address Email address, if any, must be different from the email addresses entered in section(s) above; otherwise, leave blank.

Although not required, providing the Veteran’s email address may reduce the time it takes to process your inquiry by helping us to match identifying information.

Veteran Email Address Email address, if any, must be different from the email addresses entered in section(s) above; otherwise, leave blank.

Re-enter a value for the field 'Veteran Email Address'

Daytime Phone

Veteran Phone Number

Country

Veteran Country

Street

Veteran Street

City

Veteran City

State

Veteran State

Postal Code

Veteran Zip Code

Veteran Service Information

If known, please provide Branch of Service, Social Security Number, Claim Number and/or Service Number, Date of Birth, and Service Dates for the Veteran.

Branch of Service If more than one branch of service, enter last branch.

Providing as many of these identifying pieces of data as possible will reduce the time it takes to process your inquiry, by helping us better match information.

SSN (No Hyphens) Press right arrow and then down arrow key to access tooltip If your claim number is the same as your Social Security Number, enter it here (type all numbers, no hyphens). Veteran SSN (No Hyphens) Press right arrow and then down arrow key to access tooltip If your claim number is the same as your Social Security Number, enter it here (type all numbers, no hyphens).	Claim Number (Other than SSN) Claim Number format must be: 6, 7 or 8 numeric digits. Enter numbers only. Do not include 'C' or other letters, spaces, or periods. Vet Claim Num(other than SSN) Claim Number format must be: 6, 7 or 8 numeric digits. Enter numbers only. Do not include 'C' or other letters, spaces, or periods.	Service Number (If Service Number is other than your SSN or claim number, enter it here. Enter 12 digits, numbers only; no hyphens, spaces, etc.) Veteran Service Number (If Service Number is other than your SSN or claim number, enter it here. Enter 12 digits, numbers only; no hyphens, spaces, etc.)
Date of Birth Press right arrow and then down arrow key to access tooltip (MM-DD-YYYY) Veteran Date of Birth Press right arrow and then down arrow key to access tooltip (MM-DD-YYYY)	Date Entered Active Duty Press right arrow and then down arrow key to access tooltip (MM-DD-YYYY) Date Entered Active Duty Press right arrow and then down arrow key to access tooltip (MM-DD-YYYY)	Date Released Active Duty Press right arrow and then down arrow key to access tooltip (MM-DD-YYYY) Date Released Active Duty Press right arrow and then down arrow key to access tooltip (MM-DD-YYYY)

Please click on the "Submit" button JUST ONE TIME. There may be a delay as long as 25 seconds while your information is routed electronically to the appropriate office. Again, please click only once. Processing is complete when your screen changes to an acknowledgement from VA that your message has been received.

VA Form 0873
DEC 2005

OMB Number: 2900-0619
11/30/2019
Estimated Burden: 10 minutes

The Paperwork Reduction Act of 1995 requires us to notify you that this information collection is in accordance with the clearance requirements of section 3507 of the Paperwork Reduction Act of 1995. We may not conduct or sponsor, and you are not required to respond to, a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all individuals who must complete this form will average ten (10) minutes. This includes the time it will take to read instructions, gather the necessary facts and fill out the form. This collection of information is intended to fulfill the need identified by the Department of Veterans Affairs (VA) to categorize your question, complaint, compliment, or suggestion and collect the necessary information to respond to it. Results will be used to automatically route your inquiry to the appropriate person in the VA, which will help ensure that you receive a response in a timely manner. Use of this form is voluntary and failure to participate will have no adverse effect of benefits to which you might otherwise be entitled.

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