What toxins were you exposed to in service that you believe led to your condition?

Where were you stationed at the time of exposure?

When were you stationed there and for how long?

How often were you exposed?

Why do you believe this exposure caused or aggravated your condition?

When did you start experiencing symptoms? Explain how your symptoms have worsened over time:

Describe how these symptoms affect your day-to-day life at home and at work.