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Identify and Submit a Lead

Use the "Basic Qualifications" link to learn what a person needs to qualify as an Aid and Attendance pension candidate. 

 

To have a list of questions to use in intake conversations, use the "Prescreening Questions."

Have a question or need help? Contact Cheri McElroy at cheri@patriotpension.com or call 254-315-5325

1. Identify

2. Submit

After you determine that the lead is a good candidate, please submit the information through our online form below.

 

Alternatively, you can print the form, fill it out and mail back to me (instructions on the printout).

Agency Submission Form

Please use the following questions to let us know about your lead. If you do not have an answer, please write "N/A." You can add additional comments at the bottom of the form if needed.

CONTACT INFO

REFERRING HOME CARE AGENCY CONTACT INFORMATION

THE VETERAN OR SURVIVING SPOUSE'S INFORMATION

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PRIMARY CONTACT PERSON (if applicable)

MILITARY

The Vet must have served at least one day during wartime, and 90 active days total. Which period(s) did the Veteran serve?

7 Dec 1941 - 31 Dec 1946

27 June 1950 - 31 Jan 1955

28 Feb 1961 - 7 May 1975 - Served in the Republic of Vietnam (South Vietnam)

5 Aug 1964 - 7 May 1975

2 Aug 1990 - present

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Medical

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Money

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BONUS ROUND - completely optional

Thanks for submitting!

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