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U.S. Department of Defense Form DD2766 ADULT PREVENTIVE AND CHRONIC CARE FLOWSHEET FORM NUMBER DD2766 FORM TITLE ADULT PREVENTIVE AND CHRONIC CARE FLOWSHEET U.S. GOVERNMENT AGENCY U.S. Department of Defense U.S. DoD POINTS OF CONTACT U.S. DoD Forms Management Officer USERS U.S. Department of Defense FILE FORMATS PDF OPTIMIZED T PRINTABLE FILLABLE SAVABLE OBTAINING FROM 1 DoD. gov 2 USA-Federal-Forms. com 3 Fillable. com ISSUANCES ADOPTED PRESCRIBED PREVIOUS EDITIONS ACCEPTED FORM CONTROLLED...

How to fill out dd2766 form

How to fill out dd2766:

1. Begin by gathering all the necessary information and documentation required to fill out dd2766. This includes personal identification details such as name, address, social security number, and contact information.
2. Review the purpose of dd2766, which is the Department of Defense (DoD) form used to establish the medical record of an individual being examined for military fitness or suitability, or seeking medical care at a military treatment facility.
3. Start filling out the form by providing the individual's name and other required biographical information. Ensure the information is accurate and up-to-date.
4. Move on to section I, which requires disclosure of any medical conditions, illnesses, or injuries relevant to the physical examination or medical treatment. Provide detailed and accurate information in this section to ensure a comprehensive medical record is established.
5. Proceed to section II, which focuses on past medical history. Fill in any relevant details about previous surgeries, hospitalizations, or treatments, as applicable. It is important to be thorough and truthful in this section.
6. In section III, list any medications the individual is currently taking. Include the medication name, dosage, and frequency of use. This information helps medical personnel understand the individual's current medication regimen.
7. Section IV is intended for recording the results of the physical examination. This includes measurements such as height, weight, blood pressure, and other pertinent observations made during the examination.
8. If necessary, additional sections and attachments may be included for specific medical evaluations, such as a dental evaluation or an optometry evaluation. Ensure all relevant sections are completed accurately.

Who needs dd2766:

1. Individuals undergoing a military fitness or suitability examination require dd2766. This form is used to establish their medical record and ensure they are physically fit for military service.
2. Individuals seeking medical care at a military treatment facility may also need a dd2766. This form helps establish their medical history and provide necessary information for medical professionals to provide appropriate care.
3. Medical professionals and administrators within the military healthcare system utilize dd2766 to maintain comprehensive medical records and support the overall healthcare delivery process.

It is important to note that the specific requirements and procedures for filling out dd2766 may vary based on the intended purpose and the guidelines provided by the institution or organization requesting the form.

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