Completing the Registry Questionnaire

The online questionnaire will take about an hour to complete, depending on your number of deployments. You can fill out the questionnaire in multiple sittings by saving your information and returning later to complete it.

You will be asked a series of questions in the following categories:

• Where and when you were deployed
• Conditions and health issues that cause difficulty with daily activities
• Current and past health symptoms
• Where you've lived
• The type of work you do and have done
• Dust, gas, vapors, or fumes exposures
• Home environment and hobbies
• How and when you seek health care
• Contact preferences

You can save your progress and return to the questionnaire as many times as you like, but you will not be able to revise your responses or add deployments after you submit your questionnaire.

It is important for medical providers to have a complete picture of your health. The questionnaire asks a broad range of questions because an individual’s health is greatly influenced by their lifestyle. Health conditions can worsen over time from additional or prolonged exposures experienced during work or recreation. Your current or past jobs, hobbies, civilian exposures, and lifestyle will not affect eligibility for benefits.

Your personal information will be secure and VA will review it for authorized purposes only. Registry data will be provided to other government agencies (including DOD), research institutions, and the general public, but your identity will not be linked to it. You are responsible for protecting your personal information that you print out or download.

DOD providers can access completed questionnaires in the Individual Longitudinal Exposure Record (ILER). However, to avoid technical issues, please bring a printed copy of your questionnaire or securely submit an electronic copy when you attend your registry evaluation and/or your next routine health assessment (such as your Periodic Health Assessment or Post-Deployment Health Assessment). Sharing your completed questionnaire can help your provider obtain a comprehensive picture of your health and potential health concerns.

Yes, everyone who registers for the Airborne Hazards and Open Burn Pit Registry can download and/or print a copy of their completed questionnaire upon submission. You can also log back in to the registry to access it anytime.