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INSTRUCTIONS FOR COMPLETING DD FORM 27921,
EXCEPTIONAL FAMILY MEMBER
SPECIAL EDUCATION/EARLY INTERVENTION Summary DD Form 27921 is completed to identify a
family member with special educational/early
intervention
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How to fill out dd form 2792-1 20060621
How to fill out dd form 2792-1 20060621
01
To fill out the DD Form 2792-1 20060621, follow these steps:
02
Start by filling out your personal information in Section I. This includes your name, date of birth, military status, and contact information.
03
In Section II, provide information about your primary care provider (PCP). Include their name, address, phone number, and specialty.
04
If you have any specialized medical needs or require special education services, mark the appropriate boxes in Section III.
05
For Section IV, provide information about any other healthcare providers you see regularly. Include their names, addresses, phone numbers, and specialties.
06
In Section V, indicate if you have any family members who require special education or early intervention services.
07
If you or any of your family members have any special medical or educational needs, provide the details in Section VI.
08
Section VII requires you to sign and date the form.
09
Lastly, make sure to review the completed form for accuracy before submitting it.
10
Remember, it is important to fill out the form accurately and completely to ensure appropriate healthcare services and support for you and your family.
Who needs dd form 2792-1 20060621?
01
DD Form 2792-1 20060621 is required for active duty service members and their family members who may have special medical or educational needs.
02
It is also used for National Guard and Reserve members who are on active duty or activated for more than 30 consecutive days.
03
The form helps to determine eligibility for the Exceptional Family Member Program (EFMP) and ensures that necessary medical and educational services are available at the assigned duty location.
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