Non Disclosure
Combat Wounded Coalition collects the following information and may use and provide it to other organizations, either For-Profit or Non-Profit, that may offer services to veterans or wounded warriors that may be of interest to you in support of Combat Wounded Coalition's mission. If you authorize Combat Wounded Coalition to disclose your information based on the needs you have identified, Combat Wounded Coalition may disclose your name, address, phone number, service information and injuries. Combat Wounded Coalition will not otherwise sell your information to any third party and will not otherwise disclose your information to any organization that does not serve veterans or wounded warriors. Although Combat Wounded Coalition does everything in our power to research and vet our partner organizations, Combat Wounded Coalition is not liable for the actions of any other organization or person. By clicking “YES” you consent to the disclosure of your information by Combat Wounded Coalition to partner organizations who offer services to veterans and/or wounded warriors for the needs you have identified. If you do not want Combat Wounded Coalition to disclose your information, click “NO.”
About You
Contact Information
A caregiver can be defined as a spouse, a significant other, or a parent who is currently providing you with either part-time of full-time support.
Military Service
Combat Injury
Combat Wounded Coalition Clothing Kit
Combat Wounded Coalition offers a free clothing kit to combat wounded personnel. This clothing kit contains fashionable clothing including shirts that depict the Purple Heart Medal and other designs from Combat Wounded Coalition. This kit is provided free of charge to all combat wounded personnel (Purple Heart Recipients) from all conflicts. Combat Wounded Coalition can also provide clothing modifications for a wounded warrior. This clothing can be uniforms or civilian clothing and will be modified free of charge. Please select yes if you would like clothing alterations.
VA Rating
Other Services
The Combat Wounded Coalition continues to partner with other nonprofits and organizations to best support the needs of our program recipients. By answering Yes to any of these questions, your name and contact information will be shared with them so they can attempt to provide services.
More information
  • Files must be less than 2 MB.
  • Allowed file types: gif jpg jpeg png bmp eps txt pdf doc docx zip.
Thank you for taking the time to register with us. If you are experiencing technical difficulties uploading your verification documents please send them to