Get the free DD Form 771, Eyewear Prescription, July 1996 - med navy
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EYEWEAR. PRESCRIPTION. DATE ... SPECIAL COMMENTS/JUSTIFICATION (*Use this space to specify blocks marked “Other.”) PRESCRIBING OFFICER/ AUTHORITY. SIGNATURE. DD FORM 771, JUL 96 (EG) ... ACCOUNT
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How to fill out dd form 771 eyewear
How to fill out DD Form 771 Eyewear:
01
Start by entering the year, month, and day on the corresponding lines at the top of the form.
02
Provide your full name and rank or grade in the next section. Make sure to write legibly and accurately.
03
Indicate your service branch by checking the appropriate box (Army, Navy, Air Force, Marines, Coast Guard).
04
Write down your complete military address in the designated space. Include your unit or organization, APO/FPO/DPO, and ZIP code.
05
In the "Date of Prescription" field, fill in the date when your eyewear prescription was issued by an authorized optometrist or ophthalmologist.
06
Specify whether this is a new prescription or a renewal by checking the appropriate box.
07
If applicable, provide the prescription number given by the eye care professional or clinic.
08
Indicate the type of eyewear needed by checking one of the following options: Glasses (spectacles), Contact Lenses, or Both.
09
Enter the details of your prescription, including the Sphere (SPH), Cylinder (CYL), Axis, Prism, Base Direction, and Add Power, if applicable. Ensure the information matches your prescription accurately.
10
If you are authorized a bifocal prescription, check the appropriate box and specify the segment height (SH) in millimeters.
11
If your prescription includes tinted lenses, check the box and describe the desired color under "Remarks."
12
Sign and date the bottom of the form to certify the information provided.
Who needs DD Form 771 Eyewear?
01
Military personnel requiring eyewear prescriptions to meet vision standards for their service branch.
02
Individuals who serve in the Army, Navy, Air Force, Marines, or Coast Guard and need corrective lenses or contact lenses.
03
Military personnel who have experienced changes in their vision or have had a previous eyewear prescription expire.
04
Those who require tinted lenses for specific occupational or medical reasons, as authorized by their eye care professional.
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What is dd form 771 eyewear?
DD Form 771 eyewear is a form used to request eyewear for military personnel.
Who is required to file dd form 771 eyewear?
Military personnel who require eyewear are required to file DD Form 771.
How to fill out dd form 771 eyewear?
To fill out DD Form 771 eyewear, provide the required information such as prescription details and submit the form to the appropriate authority.
What is the purpose of dd form 771 eyewear?
The purpose of DD Form 771 eyewear is to ensure that military personnel receive the necessary eyewear for their vision needs.
What information must be reported on dd form 771 eyewear?
The information reported on DD Form 771 eyewear includes prescription details, personal information of the military personnel, and any specific requirements.
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