Get the free DD Form 771, Eyewear Prescription, July 1996

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(THIS FORM IS SUBJECT TO PRIVACY ACT OF 1974 Use DD Form 2005.)EYEWEAR PRESCRIPTIONACCOUNT NUMBERDATETO: (Lab)ORDER NUMBERFROM:NOSTRADAMUS (Last, First)Last 4 onlyGRADEADDRESS/UNITPHONEADDRESS CONTINUEDSHIP

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How to fill out dd form 771 eyewear

01

To fill out DD Form 771 Eyewear, follow these steps:

02

Start by entering the patient's information in Section I. This includes the patient's name, rank, and social security number.

03

In Section II, provide the patient's unit identification code, as well as the date of the exam and the examiner's name.

04

Next, in Section III, you'll need to record the patient's prescription information. This includes the sphere power, cylinder power, axis, and prism.

05

If any additional information is needed, such as for bifocal or multifocal lenses, make sure to accurately fill out Section IV.

06

Finally, complete Section V by providing your own information as the examiner. This includes your name, rank, and signature.

07

Remember to review the form for accuracy before submitting it.

Who needs dd form 771 eyewear?

01

DD Form 771 Eyewear is needed by military personnel who require prescription eyewear. This form is used to document and prescribe corrective lenses for authorized individuals within the military.

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What is dd form 771 eyewear?

DD Form 771 is a form used to document the issue of eyewear to military personnel.

Who is required to file dd form 771 eyewear?

Military personnel who are issued eyewear are required to file DD Form 771.

How to fill out dd form 771 eyewear?

DD Form 771 should be filled out by providing information such as name, rank, unit, type of eyewear issued, and date of issue.

What is the purpose of dd form 771 eyewear?

The purpose of DD Form 771 is to document the issue of eyewear to military personnel for record-keeping purposes.

What information must be reported on dd form 771 eyewear?

Information such as name, rank, unit, type of eyewear issued, and date of issue must be reported on DD Form 771.

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