The purpose of this survey was to help answer dozens of questions pertaining to Desert Storm,
this is not connected with the DOD or Government in any way. It was created by a Disabled Vet
to help other Vets in their own quest for the truth. If you have difficulty understanding this
survey or are medicated and require assistance then get a family member or friend to fill this
out and sign an affidavit later to confirm it's contents.
 At a later date It may be necessary to call or write you to confirm this information is correct
 and that you area real person. It is necessary to prove this testimony is authentic in every right.
At a later date this material will be submitted to congress, and it is important that all material
is truthful and accurate.



1.Your Name:

1a. Email Address

2.Your Address:

3. City / State:

4. Zip:

5. Phone :

6. Unit served in (during war):

7. Status?

Active Duty?


Medically Retired?


Dishonorably Discharged?

8.What time frame did you serve in Desert Shield/Desert Storm?

9. Were you involved in intelligence gathering in theatre before ground assault?

10. Were you part of air missions flown over Iraq during air assault?

11.Did you load ammunition for planes, tanks, howitzers etc.?

12. Did you serve food to enlisted troops in Theatre?
Yes No

13. Did you receive more than one shot before deploying and do you have you're shot records?
Yes No

14. During beginning of war, did you witness any missiles - explosions-artillery shells - mines within 2 miles of your own position?
Yes No

15. When missiles were reported inbound, were you instructed not to mop up?
Yes No

16. Did you take the PB tabs as demanded, and were you under orders to do so?
Yes No

17. During the battle was your unit asked to perform unusual or hazardous tasks that seemed unnecessary?
Yes No

18. When missiles were inbound and you could see them, after interception did you witness a single or double explosion?
Single Double

19. When mines detonated around you, was it very loud or muffled?
Loud Muffled

20. Did you witness Iraqi's firing RPG's at vehicles or helicopters?
Yes No

21. At any time did you witness bizarre events during key battles?
Yes No

22. Did anyone you know get killed during battle?
Yes No

23. During final night of the ground assault, what would you say was the average amount of ammunition (i.e. missiles - rounds -etc>) you saw being fired from both sides during one hour?1050100 5001000  unknown

24. After the cease fire, what was your current position?

25. Did you participate in Operation Denial?
Yes No

26. Did you detonate any ammunition or bunkers?
Yes No

27. When detonating sites, were you under orders to not mop up?
Yes No

28. Did you witness bunker or other demolitions?
Yes No, if so, what?

29. Were you camped under or near burning oil wells?
Yes No How long?

30. Did the smoke from the oil well fires persist over your site continuously?
Yes No

31. Were you sick at any point after the ground assault while in Kuwait/Iraq/ Saudi Arabia?
Yes No

32. How often do you remember being in any sand storms?every3days every5 days only once.

33. Is there anything about your time in Iraq/Kuwait that you feel was bizarre, unanswerable, that you care to share?

34. After coming back to America, were you given a complete physical?
Yes No

35. Have you experienced health problems since the war?Yes No if so, what?

36. Have you filed a claim with your local Veteran's Administration?
Yes No

37. Was your claim refused?Yes No
For what reasons? 
How often was claim refused? 

38. Did you receive any testing through VA?Yes No
If so, what was the conclusion?

39. Do you receive the VA PERSIAN GULF REVIEW or any other DS documentation?
Yes No

40. Do you suffer from sexual dysfunction or reproductive problems of any kind?
Yes No

41. Do you have skin or hair disorders?
Yes No

42. Do you have Nervous twitches or tremor problems?
Yes No

43. Do you have memory lapses?
Yes No

44. Chronic or semi constant fatigue?
Yes No

45. Visual blurriness or tunnel vision?
Yes No

46. Do you have digestive disorders, or constant diarrhea?
Yes No

47. Are you in constant pain?
Yes No

48. Are you receiving psychiatric treatment?
Yes No

49. Are you presently heavily medicated?
Yes No

50. Have you received any documentation from the DOD asking if you

would like to waive your rights to any further medical assistance?
Yes No

51. Do you suffer from sleep disorders?
Yes No

52. Are you much more aggressive and hostile than before the war?
Yes No

53. Have you tried to contact any members of government?
Yes No

54. Have you received any responses from the government to inquiries about Desert Storm?
Yes No

55. Have you been visited by Defense Department Agents?
Yes No

56. Do you know anyone from Desert Storm who has died since the war?Yes No Who? 

57. Have you been propositioned by the VA to assist in debunking veterans for compensation? Yes No In what way? 

58. Have you been threatened by Defense Department Agents, or asked to remain silent as to specific incidents related to the war?
Yes No

59. To the best of your knowledge, this information you have given is accurate . You understand that lying on any question will render the whole document useless, and will not aid this investigation?.
Yes No

Note: over 1,800 surveys returned since September 1st,1997

This information above is strictly for use as information gathering and is not to
be shared with anyone save Government Investigative sources. . This is not any
way going to be used to hinder Veterans or discourage them. Thank You for
Defending your country and GOD bless you.

If you have further input or comments. Please send them to
P.O. Box 414, Crawford TX 76638

e-mail  =  DSBR(AT)