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How to fill out da form 2792 1

How to fill out DA Form 2792-1:

1. Start by obtaining a copy of DA Form 2792-1, also known as the Family Member Medical Summary, from the appropriate military or healthcare facility.
2. Provide your personal information in the first section of the form. This includes your name, social security number, date of birth, and contact information.
3. Indicate your relationship to the service member in the next section. This could be spouse, child, parent, or other dependent.
4. In the medical history section, provide details about any significant medical conditions or illnesses you or your family member may have. Include the names of the conditions, the dates of diagnosis, and any ongoing treatment.
5. List any current medications being taken by you or your family member, including the names of the medications, dosages, and frequency of use.
6. If applicable, indicate if there are any allergies to medications, food, or other substances. Provide specific details about the allergies and their reactions.
7. The next section asks for information regarding any hospital stays or surgeries. List the dates, reason for hospitalization or surgery, and the facility where it took place.
8. Provide any additional information that may be relevant to the medical history of you or your family member. This could include previous illnesses, mental health conditions, or other important details.
9. Remember to sign and date the form to certify that the information provided is accurate to the best of your knowledge.

Who needs DA Form 2792-1:

1. Service members and their dependents who are seeking medical care at a military or healthcare facility may need to fill out DA Form 2792-1.
2. This form is commonly used to gather important medical information about family members that may impact their healthcare needs and treatment.
3. It is typically required for military personnel and their dependents who are seeking medical care through the TRICARE system or other military healthcare providers.
4. The form helps healthcare providers assess the medical needs and potential risks of military members and their families, ensuring appropriate care and treatment can be provided.

For pdfFiller’s FAQs

What is da form 2792 1?

DA Form 2792-1 is the Family Member Deployment Screening Sheet, used by the United States Department of the Army.

Who is required to file da form 2792 1?

Family members of military personnel who are preparing for deployment are required to file DA Form 2792-1.

How to fill out da form 2792 1?

DA Form 2792-1 must be filled out with accurate and detailed information regarding the family member's health and well-being in preparation for military deployment.

What is the purpose of da form 2792 1?

The purpose of DA Form 2792-1 is to assess and address the well-being of family members of military personnel before deployment and provide necessary support.

What information must be reported on da form 2792 1?

Information such as medical history, current health status, emotional well-being, and any special needs or accommodations required must be reported on DA Form 2792-1.

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