BUDDY STATEMENT TEMPLATE

BUDDY STATEMENT FOR VA CLAIM

A buddy statement is a written statement from someone who knows you (friend, family member, fellow service member) describing your condition and how it affects your daily life.

VETERAN INFORMATION

Veteran's Full Name *

Condition(s) You Are Supporting

WITNESS INFORMATION

Your Full Name *

Relationship to Veteran *

Your Email *

Your Phone *

How long have you known the veteran? *

Your Statement *

Tip: Include specific incidents you've witnessed, changes you've observed in their behavior or abilities, and how their condition impacts daily activities.

SIGNATURE & DATE

Witness Signature

Sign here

Date

WHAT TO INCLUDE IN A BUDDY STATEMENT:

• Describe the circumstances that led to the condition or injury
• Your relationship to the veteran and how long you've known them
• Specific observations of the veteran's condition or symptoms
• Changes you've witnessed in their behavior, mood, or abilities
• Examples of how their condition affects daily activities
• Impact on work, relationships, or social activities you've observed
• Any assistance you provide or have provided