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Va 21 0960q 1 2016-2023
(VA) for disability benefits. VA will consider the information you provide on this questionnaire
as part of their evaluation in processing the veteran's claim. VA reserves the right to confirm the authenticity of ALL DBQs completed by private health care providers.
1A. DOES THE VETERAN NOW HAVE OR HAS HE OR SHE EVER BEEN DIAGNOSED WITH CHRONIC FATIGUE SYNDROME?
YES
NO
(If "Yes," complete Item 1B)
: These are the diagnoses determined during this current evaluation of the claimed condition(s)...
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