DD Form 2792-1 2011 free printable template
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SPECIAL EDUCATION/EARLY INTERVENTION SUMMARY
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 136; 20 U.S.C. 927; Jodi 1315.19: Jodi 1342.12; and E.O. 9397 (SSN) as amended.
PRINCIPAL PURPOSE(S): Information
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How to fill out DD Form 2792-1
How to fill out DD Form 2792-1
01
Download DD Form 2792-1 from the official government website.
02
Fill out the identification section with the patient's information, including full name, date of birth, and social security number.
03
Provide the sponsor's information, including name, rank, and social security number.
04
Indicate the nature of the medical condition or disability in the appropriate section.
05
Include any additional information required in the comments section.
06
Review the completed form for accuracy and completeness.
07
Sign and date the form.
08
Submit the form to the appropriate military medical authority or designated official.
Who needs DD Form 2792-1?
01
Individuals who have a family member with special needs and are seeking medical or educational services.
02
Active duty military members and their families who require documentation of medical conditions.
03
Persons applying for additional benefits related to medical conditions or disabilities.
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What is a 2792 form?
GENERAL. The DD Form 2792 is completed to identify a family member with special medical needs. There is a Certification Section on page 3 that should be signed AFTER the entire form is completed by medical provider(s) and the form has been reviewed for completeness and accuracy.
What is DD Form 2792-1?
The DD Form 2792-1 is completed to identify a family member with early intervention / special education needs. DEMOGRAPHICS. Items 1 - 7. To be completed by sponsor, spouse, legal guardian, or student who has reached the age of majority.
What is a dd2792 1 for?
The DD Form 2792-1 is completed to identify a family member with special educational/early intervention needs.
What is DD Form 2792 used for?
The DD Form 2792 and attached addenda are completed to identify a family member with special medical needs. The addenda to the medical summary are completed only if noted in Item 9 of the Demographics/Certification section.
Who fills out EFMP paperwork?
You are responsible for their completeness and accuracy. An official at your child's school must complete Addendum B Special Education. Both medical and educational portions must be completed for children 3-18 years of age. The treating physician(s) should complete the medical forms.
What is the DD Form 2792 for?
The DD Form 2792 and attached addenda are completed to identify a family member with special medical needs.
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What is DD Form 2792-1?
DD Form 2792-1 is a Department of Defense form used to document the special needs of a family member of a service member.
Who is required to file DD Form 2792-1?
Service members who have family members with special needs are required to file DD Form 2792-1.
How to fill out DD Form 2792-1?
To fill out DD Form 2792-1, provide accurate information about the family member's special needs, including diagnosis, services required, and relevant supporting documents.
What is the purpose of DD Form 2792-1?
The purpose of DD Form 2792-1 is to assess the special needs of family members, ensuring they receive appropriate services and support.
What information must be reported on DD Form 2792-1?
Information that must be reported on DD Form 2792-1 includes the family member's name, relationship to the service member, nature of the special needs, and any required medical services or treatments.
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