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U.S. DOD Form dod-dd-689 DATE INDIVIDUAL SICK SLIP ILLNESS INJURY LAST NAME FIRST NAM — MIDDLE INITIAL OF PATIENT SERVICE NUMBER/SSN ORGANIZATION AND STATION GRADE/RATE UNIT COMMANDER'S SECTION
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How to fill out dd 689 form
How to Fill Out DD 689:
01
Start by entering the date at the top of the form.
02
In the "Name" section, write your full name as it appears on your military identification card.
03
Enter your Social Security Number in the corresponding field.
04
Provide your Date of Birth and Gender.
05
Indicate your Unit or Organization.
06
In the "Address" section, enter your current mailing address.
07
In the "Phone Number" field, write your contact number.
08
If applicable, enter your military rank in the "Rank" section.
09
Enter the name of your supervisor or commanding officer.
10
In the "Employer" section, write the name and address of your civilian employer if you have one.
11
For Part I, indicate the medical condition or injury that is being reported.
12
Provide the date and time the injury occurred, as well as the location.
13
Describe the circumstances surrounding the injury or medical condition.
14
If there were any witnesses present, include their names and contact information.
15
In Part II, provide information about the medical treatment received.
16
Enter the date of treatment and the name of the medical facility or physician.
17
Briefly describe the treatment received and any medications prescribed.
18
If there were any follow-up appointments scheduled, include the details.
19
In Part III, sign and date the form.
20
If you have any supporting documentation, attach it to the form before submitting.
Who Needs DD 689:
01
Service Members: Any military personnel who have suffered an injury or developed a medical condition while on active duty may need to fill out DD 689.
02
Veterans: Individuals who have been discharged from the military but have ongoing medical issues related to their service may also require the use of DD 689.
03
Military Medical Personnel: Medical professionals involved in the treatment and documentation of service member injuries or medical conditions often utilize DD 689 for record-keeping purposes.
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What is dd 689?
DD Form 689 is the Individual Sick Slip used by the military for reporting the status of a service member's duty limitation due to illness or injury.
Who is required to file dd 689?
Service members who are experiencing illness or injury that affects their duty limitation are required to file DD Form 689.
How to fill out dd 689?
DD Form 689 should be filled out with the service member's personal information, details of the illness or injury, and any limitations on duty as directed by medical personnel.
What is the purpose of dd 689?
The purpose of DD Form 689 is to document and track the status of a service member's duty limitation due to illness or injury.
What information must be reported on dd 689?
Information such as the service member's personal details, diagnosis, duty limitations, and dates of medical treatment must be reported on DD Form 689.
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