• Applicant Information

  • If no, did you receive Imminent Danger Pay?
  • If yes, what%?
  • If yes, what%?
  • If yes, what are your symptoms?
  • Marital Status

  • Emergency Contact Information

  • Relationship
  • Military Service

  • Prescribed Medications

  • Disclaimer and Signature


After you submit application, please scan a copy of your DD214 and VA Disability Letter and email to warrior@ptsdusa.org


What to Bring With You

  • 1 Week of Clothes
  • Shoes
  • Medications
  • You won’t need to bring anything else to complete the program.