Get the free da form 3365

AUTHORIZATION FOR MEDICAL WARNING TAG For use of this form, see AR 40-15; the proponent agency is Office of The Surgeon General. TO: (Include ZIP Code) FROM: (Medical Treatment Facility (Specify Clinic,

How to fill out da form 3365

How to Fill Out DA Form 3365:

1. Start by opening the DA Form 3365, which is the Casualty Feeder Card.
2. Fill in the header section with the necessary information, including the Soldier's name, social security number, rank, and unit.
3. In the Medical Treatment Facility (MTF) Claims Contact Information section, provide the name of the MTF, address, phone number, and fax number.
4. Next, provide the casualty's personal information, such as last name, first name, middle initial, date of birth, social security number, blood type, and rank.
5. Proceed to the Casualty Status section and choose the appropriate status for the casualty, such as wounded in action (WIA), killed in action (KIA), died of wounds (DOW), or other.
6. In the Cause, Site, and Date of Casualty section, specify the cause of the casualty, the location, and the date it occurred.
7. Fill out the Witnesses section if applicable, providing the names, ranks, and contact information of any witnesses to the casualty.
8. In the Evacuation Data section, provide details about the evacuation, including the method of transportation and the dates.
9. In the Administrative Data section, indicate the date the form is prepared, the soldier preparing the form, and the unit's name and location.
10. Finally, review the completed form for accuracy and ensure all sections are correctly filled out before submitting it as required by the appropriate regulations.

Who Needs DA Form 3365:

1. DA Form 3365 is required for any soldier who sustains a casualty, such as being wounded in action, killed in action, or dying of wounds.
2. This form is used to document the necessary information related to the casualty, including personal details, cause of the casualty, evacuation data, and administrative information.
3. The form is needed for official record-keeping purposes, as well as for providing crucial information to medical treatment facilities and other relevant personnel.
4. The form is typically filled out by the soldier's unit or medical personnel who are responsible for reporting and documenting casualties in the military system.

For pdfFiller’s FAQs

How do I modify my da form 3365 in Gmail?

You may use pdfFiller's Gmail add-on to change, fill out, and eSign your da form 3365 as well as other documents directly in your inbox by using the pdfFiller add-on for Gmail. pdfFiller for Gmail may be found on the Google Workspace Marketplace. Use the time you would have spent dealing with your papers and eSignatures for more vital tasks instead.

How do I edit da form 3365 online?

With pdfFiller, the editing process is straightforward. Open your da form 3365 in the editor, which is highly intuitive and easy to use. There, you’ll be able to blackout, redact, type, and erase text, add images, draw arrows and lines, place sticky notes and text boxes, and much more.

How do I make edits in da form 3365 without leaving Chrome?

Download and install the pdfFiller Google Chrome Extension to your browser to edit, fill out, and eSign your da form 3365, which you can open in the editor with a single click from a Google search page. Fillable documents may be executed from any internet-connected device without leaving Chrome.

What is da form 3365?

The DA Form 3365 is a United States Army form used for reporting the status of non-unit-owned communication-electronics equipment.

Who is required to file da form 3365?

Individuals responsible for non-unit-owned communication-electronics equipment are required to file the DA Form 3365.

How to fill out da form 3365?

To fill out the DA Form 3365, provide information about the equipment such as the nomenclature, serial number, condition, and any repairs or scheduled maintenance performed.

What is the purpose of da form 3365?

The purpose of the DA Form 3365 is to track and maintain the status of non-unit-owned communication-electronics equipment.

What information must be reported on da form 3365?

The DA Form 3365 requires reporting of information such as the nomenclature, serial number, condition, repairs, and scheduled maintenance performed on non-unit-owned communication-electronics equipment.