AFCS Review Form

title * Please select... Mr.Mrs.MissMsDr.

first name *

surname *

address *

city *

country *

postal code *

telephone *

email *

date of birth

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Service Number

National Insurance Number

AFCS Claim Number

Date of application to AFCS

Any time limits or deadlines imposed by the AFCS with notification of proposed award

Details of the compensation award proposed by the AFCS

Details of the injury you have sustained, illness suffered or disability caused by the service

Date of injury, illness or disability

Circumstances surrounding and resulting in your injury, illness or disability

Do you consider that the MOD were responsible for the events leading up to your injury, illness or disability?

How do you feel the MOD or its agents could have avoided your injury, illness or disability from occurring?

Have you received any independent legal advice in respect of your claim, injury, illness or disability?