Get the free dd form 2627 - reginfo

OMB No. 07040347 OMB approval expiresREQUEST FOR GOVERNMENT APPROVAL FOR AIRCREW QUALIFICATIONS AND Training public reporting burden for this collection of information is estimated to average 5 minutes

How to fill out dd form 2627

How to fill out DD Form 2627?

Ensure all necessary information is provided:

1. Start by accurately entering the date in the specified section.
2. Fill in your full name, rank, and social security number in the corresponding fields.
3. Provide your contact information, including address, phone number, and email.

Identify the source of the health care:

1. Indicate whether you received care from a military treatment facility or a civilian care provider.
2. Enter the name of the facility or provider, their address, and contact information.

Record the details of the appointment or treatment:

1. Specify the date and time of the appointment or the start and end dates of hospitalization.
2. Describe the reason for the care, such as illness, injury, or preventive procedures.
3. Provide details about the nature of the care received, including any surgeries, medications, or treatments administered.

Include information about any accompanying family members:

1. If someone accompanied you during the appointment or hospitalization, list their names and relationship to you.
2. Include their social security numbers, addresses, and contact information.

Indicate whether you have additional supporting documents:

If you have any relevant medical records or receipts, tick the appropriate box and attach the necessary documents.

Who needs DD Form 2627?

DD Form 2627 is required for any active duty service member or their dependent who seeks medical treatment or any kind of healthcare service outside of a military treatment facility (MTF). This form serves as a documentation tool to record the essential details of the care received and is typically used for reimbursement purposes. It is crucial for both the service member and the healthcare provider to accurately complete and retain this form as it enables proper tracking and processing of medical expenses.

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What is dd form 2627?

DD Form 2627 is a Department of Defense form used for reporting mishaps and accidents involving military personnel, equipment, or facilities.

Who is required to file dd form 2627?

Military personnel and civilian employees of the Department of Defense are required to file DD Form 2627 whenever a mishap or accident occurs.

How to fill out dd form 2627?

DD Form 2627 must be filled out completely and accurately, providing detailed information about the mishap or accident, including date, time, location, individuals involved, and any injuries or damages.

What is the purpose of dd form 2627?

The purpose of DD Form 2627 is to document and investigate mishaps and accidents in order to prevent future occurrences and improve safety procedures.

What information must be reported on dd form 2627?

Information that must be reported on DD Form 2627 includes the nature of the mishap or accident, individuals involved, injuries sustained, damages incurred, and any contributing factors.