[contact-form subject=”LOVME FAQ – Afghanistan (OEF)” to=”aolegacy@gmail.com”] [contact-field label=”Name” type=”name” required=”true” /] [contact-field label=”Email” type=”email” required=”true” /] [contact-field label=”Relationship to Veteran” type=”select” required=”true” options=”Veteran,Spouse,Widowed,Divorced,Child (biological),Grandchild (biological),Great-grandchild (biological),Other” /] [contact-field label=”If you chose other please tell us your relationship to the veteran” type=”text” /] [contact-field label=”Type of Military Exposure” type=”radio” options=”Burn Pits,Depleted Uranium (DU),Sand and Dust and Particulates,Toxic Embedded Fragments,Traumatic Brain Injury (TBI),PTSD,Melfoquine – Lariam,Occupational Hazards” /] [contact-field label=”If you chose Occupationa Hazards please choose which one applies to the veteran” type=”radio” options=”Industrial Solvents,Lead,Radiation,Fuels (Petroleum and Oils and Lubricants),PCBs,CARC Paint” /] [contact-field label=”Please submit your question. We will respond to you personally as soon as is possible.” type=”textarea” required=”true” /] [/contact-form]
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