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U.S. DOD Form dod-da-2696 OPERATIONAL HAZARD REPORT Requirements Control Symbol CSOCS-307 For use of this form, see AR 385-95; the proponent agency is CSA An operational hazard is any condition or

How to fill out da 2696 form

How to fill out DA 2696:

1. Begin by obtaining a copy of DA 2696 from the appropriate source, such as the official website of the United States Army or your unit's administrative office.
2. Carefully read the instructions provided with the form to understand the purpose and requirements of each section.
3. Start by filling out personal information, including your name, rank, social security number, and contact details.
4. Move on to provide the necessary information about the individual for whom the form is being completed, such as their name, relationship to you, and their current status (active duty, reserve, retired, etc.).
5. Proceed to accurately describe the medical condition or injury that prompted the completion of DA 2696. Include details such as symptoms, diagnosis, and treatment received.
6. If applicable, provide information about any personal or professional impact caused by the medical condition, such as work limitations, need for assistance, or changes in performance.
7. Sign and date the form, and ensure any required witness signatures are obtained as well.
8. Submit the completed form to the designated authority, which may be the unit's medical officer, a military hospital, or another relevant office.

Who needs da 2696:

1. Individuals who have suffered from medical conditions or injuries while serving in the United States Army may need to fill out DA 2696.
2. This form is typically required when seeking medical evaluation or treatment through military healthcare facilities.
3. It is also necessary for documenting and processing claims related to medical conditions or injuries that may have occurred during military service.

For pdfFiller’s FAQs

What is da 2696?

DA 2696 is a form used by the United States Army to document medical restrictions and limitations for soldiers.

Who is required to file da 2696?

Soldiers who have medical restrictions or limitations are required to file DA 2696.

How to fill out da 2696?

To fill out DA 2696, the soldier or their medical provider must provide detailed information about the restrictions or limitations, including the medical condition, recommended restrictions, and duration.

What is the purpose of da 2696?

The purpose of DA 2696 is to document and track the medical restrictions or limitations of soldiers to ensure they are appropriately assigned and deployed.

What information must be reported on da 2696?

DA 2696 requires information such as the soldier's name, rank, unit, medical condition, recommended restrictions or limitations, and the medical provider's information.

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