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Operation Healing Forces Retreat Application

Form submission is not a retreat guarantee, but does allow us to reach out to all those interested as quickly as possible. Your email and phone number will be used to contact you about upcoming retreats. All information shared in this application will be used to determine and verify eligibility. How you answer the questions does not determine eligibility. Your information will not be shared with any party outside of the Operation Healing Forces organization. If you have have questions or concerns regarding this application, please contact the Retreat Program Director at Billy.Delong@ophf.org.

	Yes	No
Have you ever attended an OHF retreat or are you scheduled to attend an upcoming OHF retreat?
Are you enrolled in the USSOCOM Warrior Care Program or other Warrior Care Program?
Have you been awarded a Purple Heart?
Do you have a current US Govt Commercial (Blue) Passport?

Service Member Info

Last Name

First Name

Phone Number

Phone Type

Email

Email Type

Do you have wounds, illness, or injuries?

Spouse Info

Last Name

First Name

Phone Number

Phone Type

Email

Email Type

Relationship to Service Member

Household Info

Mailing Address

Street Address

City

State

Zip Code

Total Number of Household Members

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Military Info

Home of Record City

Home of Record State

Branch

Overall Disability Rating

Service Status

Rank

Unit

MOS

Service Start Date

Service End Date

Combat Deployed

SOF Affiliation Documentation

Examples include Orders or DD-214

Combat Deployment Information

Number of Combat Deployments

Theater of Operations

Select all that apply

Non-Combat Deployment Information

Number of Non-Combat Deployments

Theater of Operations

Select all that apply

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Operation Healing Forces Retreat Application

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