Veteran Assistance Application

Thank you for your interest in applying for financial assistance for health and wellness services that are not covered by your VA insurance. If you are a post-9/11 Tennessee Veteran, please provide the information on this form so that one of our VH+WA representatives can contact you regarding your needs.

If you encounter any issues when filling out the application, please email us and we will reach out to you by the next business day.

To see how VH+WA will use your information, please see our Privacy Policy. You can opt out of this communication at any time by following the instructions outlined in our Privacy Policy.