Get the free 22-0819. DoD Referral to Integrated Disability Evaluation System (IDES)

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OMB Approved No. 29000704 Respondent Burden: 15 minutes Expiration Date: 7/31/2021VA DATE STAMP(DO NOT WRITE IN THIS SPACE)DoD REFERRAL TO INTEGRATED DISABILITY EVALUATION SYSTEM (IDES) INSTRUCTIONS:

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How to fill out 22-0819 dod referral to

01

Start by opening the 22-0819 DOD Referral form.

02

Enter the patient's name in the designated field.

03

Provide the patient's date of birth.

04

Fill in the patient's home address, city, state, and ZIP code.

05

Indicate the patient's gender.

06

Specify the branch of service for the referring provider.

07

Enter the provider's name, rank, and contact information.

08

Provide the name and address of the intended recipient.

09

Write a brief description of the reason for the referral.

10

Include any relevant medical history or documentation.

11

Fill out the remaining fields as required.

12

Review the completed form for accuracy and completeness.

13

Sign and date the form before submitting it to the appropriate authority.

Who needs 22-0819 dod referral to?

01

The 22-0819 DOD referral form is typically needed by medical providers or military personnel who need to refer a patient to another medical facility or specialist within the Department of Defense (DOD) healthcare system.

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What is 22-0819 dod referral to?

22-0819 DOD referral is to be reported to the Department of Defense for specified purposes.

Who is required to file 22-0819 dod referral to?

Certain individuals or organizations may be required to file 22-0819 DOD referral to the Department of Defense.

How to fill out 22-0819 dod referral to?

You can fill out 22-0819 DOD referral by following the instructions provided by the Department of Defense.

What is the purpose of 22-0819 dod referral to?

The purpose of 22-0819 DOD referral is for specific reporting requirements to the Department of Defense.

What information must be reported on 22-0819 dod referral to?

Specific information required to be reported on 22-0819 DOD referral will be provided by the Department of Defense.

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