Healthy Minds Healthy Bodies Personal Interest Form

Healthy Minds Healthy Bodies Personal Interest Form

If you are interested in learning more about the Healthy Minds Healthy Bodies Program for military personnel who have returned home with disabilities, please complete and submit this Personal Interest Form.

Name(Required)
Gender(Required)

Address(Required)
Do you have a Parks Direct account number?(Required)
Did you receive a discharge under honorable conditions?(Required)
Can you provide verification of honorable discharge and 10% or more disability?
Prince George's County Department of Parks and Recreation does not keep these documents on file. Documentation must be presented for visual verification only.
Beginning Date of Service(Required)
Ending Date of Service(Required)
Were you injured during active duty?(Required)
This is related to clothing fit type*