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This form must be completed electronically. Handwritten forms will not be accepted. PRE-DEPLOYMENT HEALTH ASSESSMENT PRIVACY ACT STATEMENT This statement serves to inform you of the purpose for collecting personally identifiable information through the DD Form 2795 Pre-Deployment Health Assessment. AUTHORITY 10 U*S*C. 136 Under Secretary of Defense for Personnel and Readiness 10 U*S*C. 1074f Medical Tracking System for Members Deployed Overseas DoDI 1404. 10 DoD Civilian Expeditionary...

How to fill out dd2795 form

How to fill out DD Form 2795:

1. Start by filling out your personal information in Section I of the form. This includes your name, social security number, rank, and other relevant details.
2. Move on to Section II and provide information about your medical condition, such as the date of diagnosis and any relevant medical history.
3. In Section III, provide information about your healthcare provider who is recommending or referring you for medical treatment.
4. Section IV requires you to disclose any additional medical information or documentation that may be relevant to your condition or treatment.
5. Complete Section V by signing and dating the form, acknowledging that the information provided is accurate and that you understand the purpose of the form.

Who needs DD Form 2795:

1. Military personnel who are seeking medical treatment or evaluation.
2. Individuals who have been referred by a healthcare provider for specialized medical care.
3. Those who need to provide comprehensive medical information to their healthcare provider in order to receive appropriate treatment or evaluation.

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What is dd form 2795?

DD Form 2795 is a Department of Defense (DoD) form used for pre-deployment health assessments for military personnel.

Who is required to file dd form 2795?

Service members who are being deployed for more than 30 days are required to file DD Form 2795 as part of their health assessment process.

How to fill out dd form 2795?

To fill out DD Form 2795, you must provide personal information, medical history, and any current health issues upon pre-deployment evaluation. Ensure all sections are completed accurately.

What is the purpose of dd form 2795?

The purpose of DD Form 2795 is to assess the health status of soldiers prior to deployment and to identify any medical concerns that may need to be addressed.

What information must be reported on dd form 2795?

Information that must be reported on DD Form 2795 includes the service member's personal details, medical history, medications, and any recent health changes.