Introduction: Military occupational exposures are common, with 42% of Veterans reporting exposure concerns to their Veterans Affairs (VA) providers. In support of the 2022 Pact Act, the VA War Related Illness and Injury Study Center (WRIISC) has continued to develop the Veteran Military Occupational and Environmental Exposure Assessment Tool (VMOAT). Current exposure surveys focus on a specific domain or exposure and do not address the unique multifaceted exposures of uniformed service. These limitations make it difficult to evaluate exposures in a complete and meaningful way, both clinically and for research. Current VA exposure assessments include the Toxic Exposure Screener, VA exposure Registries, and National VA WRIISC centers, in a stepwise approach. This presentation will review the VA process for evaluating Veteran military exposure concerns; describe the development of the VMOAT; and using data from a pilot study, compare the VMOAT to the DoD and VA Individual Longitudinal Exposure Record (ILER) to show how the VMOAT fills a gap in exposure evaluations. Methods: The VMOAT 1.0 has been in use since October 2020 through an IRB approved protocol. The VMOAT was developed as a comprehensive, structured, self-report questionnaire to encompass an individual’s three life phases (pre, during, post-military service) across five standard exposure domains (chemical, biological, physical, injury, and psychological) with 64 specific exposures. Programmed review of VMOAT 1.0 was completed in 2023 and VMOAT 2.0 is being introduced, with a VMOAT 3.0 review planned in 2025. The ILER is a joint DoD and VA effort, where military exposure information from multiple primary sources is available. ILER information was obtained with participant consent. Descriptive statistics and measures of association were used to compare data from these exposure tools and databases to determine the strengths and limitations of each. Results: The VMOAT is designed to be flexible for adding other novel exposures into the survey construct, and assesses exposure dose (frequency, duration, proximity, route), a critical measure lacking in other questionnaires. VMOAT 2.0 development included comprehensive review of VMOAT 1.0, with renewed face and content validation, cognitive testing, and several assessments of external validation. VMOAT 3.0 is planned for implementation across the DoD and VA, and other settings where Veteran exposures are attained. Results of the VMOAT pilot comparison with ILER are shown graphically to illustrate the strengths and limitations of each assessment method. Discussion: The VMOAT is undergoing scientifically rigorous development and validation methodologies to comprehensively evaluate Veteran military, occupational and environmental exposures in a construct not currently employed. The VMOAT fits into the existing DoD and VA stepwise exposure assessment approach as the tertiary, self-reported evaluation, either as a stand-alone or facilitated instrument, and may be supplemented by clinician interviews in research or special evaluation programs. Pilot data review shows the added value of VMOAT information. The VMOAT provides self-report information about military environmental exposures that will allow direct evaluation to objective measures of exposure and health outcomes, enhance stakeholder buy-in through direct Veteran engagement, and help guide DoD and VA environmental exposure risk mitigation and risk communication efforts.