OSDRI VA Disabilities Intake Form

Hello,

Thank you for reaching out to OSDRI for help with your VA case. Please click the like below to complete our intake form. https://form.jotform.com/kwildenhainesq/2026intake

https://form.jotform.com/kwildenhainesq/2026intake

Once you have completed the intake form, we will confirm your information and send you a representation packet to electronically sign. If you have any questions or have trouble completing the intake form, please contact our main office for assistance at 401-383-4730.

Thank you and we look forward to working with you! 😊

Hello ,

Thank you for reaching out to us to help with your VA Disability Compensation. Please follow this link to **complete our initial intake screening.**

Once you have completed the intake form, OSDRI will be reaching out to confirm your information and email you a Representation Packet to e-sign.

Within this packet are documents that give the legal team of OSDRI, including the overseeing attorney, Kailey L. Wildenhain, Esq. the authorization to represent you and your Disability Compensation Claims to the VA.

The Representation Packet contains the following documents:

• Authorization to represent you to the VA (VA Form 21-22a)
• Authorization to release medical records from private-care facilities to the VA (VA Form 21-4142)
• Attorney Fee Agreement Form.
• Client Memorandum of Understanding.

Attorney Fee Agreement: