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REGISTER OF PATIENTS (NUMERIC) 1. MEDICAL FACILITY 4. REGISTER NUMBER 2. YEAR 5. DD Form 739, JAN 82 (EG) PATIENTS NAME (Last, First, Middle Initial) PREVIOUS EDITION IS OBSOLETE. 6. 3. PAGE NUMBER
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How to fill out dd form 739
How to fill out DD Form 739:
01
Start by downloading DD Form 739 from the official website of the Department of Defense or obtain a physical copy from your unit or installation.
02
Begin completing the form by providing your personal information, including your full name, rank, social security number, and contact information.
03
Proceed to fill in the details regarding the medic or healthcare provider who is involved in your care. This includes their name, organization, and contact information.
04
Next, carefully read through the instructions and assess if any sections apply to your specific situation. For instance, if you are seeking reimbursement for medical expenses, make sure to complete the necessary sections related to that.
05
In each relevant section, provide accurate and complete information as requested. This may include details about the medical services received, dates of services, and associated costs.
06
If applicable, provide any supporting documents or paperwork as required. These may include receipts, medical records, or other documentation necessary for the completion and processing of the form.
07
Review your completed DD Form 739, ensuring that all sections are properly filled out and that all necessary information is included.
08
Once you are confident that the form is accurate and complete, submit it to the appropriate department or office as instructed.
Who needs DD Form 739?
01
Military personnel: Active duty, reserve, and National Guard members may need to fill out DD Form 739 if they require medical attention while on active duty or during authorized training.
02
Family members: Dependents of military personnel may also need to fill out DD Form 739 if they receive medical services that require reimbursement or if they are seeking special accommodations due to a medical condition.
03
Military retirees: Retired military personnel and their dependents may need to complete DD Form 739 for medical purposes, such as receiving care through the TRICARE system or applying for medical benefits.
04
Civilian employees: In some cases, civilian employees working for the Department of Defense or other related agencies may need to fill out DD Form 739 if they receive medical care that is authorized or reimbursed by their employer.
Note: The specific circumstances and requirements for using DD Form 739 may vary, so it is always advisable to consult the relevant regulations or seek guidance from the appropriate authorities to ensure compliance with the necessary procedures.
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What is dd form 739?
DD Form 739 is a medical examination form used by the Department of Defense for military personnel.
Who is required to file dd form 739?
All military personnel are required to file DD Form 739 for their medical examination.
How to fill out dd form 739?
To fill out DD Form 739, military personnel must provide their personal information, medical history, and undergo a physical examination by a healthcare provider.
What is the purpose of dd form 739?
The purpose of DD Form 739 is to ensure that military personnel are medically fit for their duties and to maintain health records.
What information must be reported on dd form 739?
Information such as medical history, current medications, allergies, and results of the physical examination must be reported on DD Form 739.
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