DD 2813 2006 free printable template

DENTIST S TELEPHONE NUMBER Include Area Code 10. DENTIST S SIGNATURE/STATE LICENSE NUMBER DD FORM 2813 SEP 2006 PREVIOUS EDITION MAY BE USED. OMB No* 0720-0022 OMB approval expires Jul 31 2009 DEPARTMENT OF DEFENSE ACTIVE DUTY/RESERVE FORCES DENTAL EXAMINATION The public reporting burden for this collection of information is estimated to average 3 minutes per response including the time for reviewing instructions searching existing data sources gathering and maintaining the data needed and...

How to fill out DD 2813

How to fill out DD 2813

1. Obtain a copy of DD 2813 from the appropriate military resource or website.
2. Begin with Section I, entering your personal information such as name, rank, and Social Security number.
3. Provide your unit or command information in Section II.
4. In Section III, indicate your health care plan choice and any necessary enrollment information.
5. Complete Section IV by signing and dating the form to certify that the information provided is accurate.
6. Review the entire form for completeness and correctness before submission.
7. Submit the completed form to the designated office as instructed.

Who needs DD 2813?

1. Active duty military personnel.
2. Reservists and National Guard members.
3. Dependent family members of service members.
4. Retirees seeking health care.

Instructions and Help about DD 2813

Laws calm legal forms guide a DD Form 2813 is a Department of Defense form used for gathering dental information for military members who will spend an extended period of time away from dental services the form is used by military physicians to determine if an applicant is fit for extended service away from dental help the DD Form 2813 is available on the Department of Defense documentation website or can be supplied through the chain of command to begin filling out the DD Form 2813 you must bring the form with you to a dental professional who can give you an examination provide your personal information in boxes 1 through 5 provide your name social security number branch of service unit and unit address the rest of the form needs to be filled out by a dentist in box 6 the dentist must rate the candidates dental condition with either a good dental rating some oral conditions which won't result in a dental emergency within 12 months or oral conditions which will result in a dental emergency within 12 months if the dentist determines that a dental emergency will arise within 12 months he or she must indicate what dental conditions exist the dentist should further describe the dental conditions if any are present that would cause a dental emergency within 12 months if x-rays were conducted on the applicant the dentist must indicate the date they were taken the dentist will then provide their name and contact information in boxes 7 through 11 once the dentist signs off on the DD Form 2813 the form is ready for submission to the Department of Defense at the address provided on the top of the form to watch more videos please make sure to visit laws calm

What is form dd 2813 dental?

Department of DefenseDepartment of Defense(11) The term “Defense Agency” means an organizational entity of the Department of Defense— (A) that is established by the Secretary of Defense under section 191 of this title (or under the second sentence of section 125(d) of this title (as in effect before October 1, 1986 )) to perform a supply or service activity ...www.law.cornell.edu › definitions › uscodeDefinition: Defense Agency from 10 USC § 101(a)(11) | LII / Legal ... Active DutyActive DutyThe term “active duty” means full-time duty in the active military service of the United States. ... Such term does not include full-time National Guard duty.www.law.cornell.edu › uscode › text10 U.S. Code § 101 - Definitions | U.S. Code | US Law | LII / Legal .../Reserve/Guard/Civilian Forces Dental Examination Form (DD FormDD FormDD FORM stands for "Department of Defense Form"acronymsandslang.com › definition › DD FORM-meaningWhat does DD FORM mean? - Definition of DD FORM - DD FORM ... 2813) This form is used to used to assist active duty and National GuardNational GuardThe Governor can activate National Guard personnel to "State Active Duty" in response to natural or man-made disasters or Homeland Defense missions. State Active Duty is based on State statute and policy and on State funds. Soldiers and Airmen remain under the command and control of the Governor.en.wikipedia.org › wiki › United_States_National_GuardUnited States National Guard - Wikipedia and Reserve members in documenting dental health for worldwide duty. It should be downloaded and given to the dental provider to complete.

People Also Ask about

What does Class 3 dental mean in military?

Class 3: Patient with an oral condition that, if not treated, is expected to result in dental emergencies within the next 12 months.

What is the Tricare DD 2813?

PURPOSE: To collect patient information necessary to determine the patient's readiness to participate in a military deployment. ROUTINE USES: Information in your records may be disclosed to other components within the Department of Defense to determine your readiness to participate in a military deployment.

What is Class 2 dental military?

Class 2 would be yellow on IMR because you have pending non-emergency dental treatment. This means the treatment needed will not cause any dental emergency or severe problems in the next 12 months.

What is the DD form for dental?

If a civilian dental exam is accomplished when a military exam is not required, it must be documented on a DD Form 2813, Department of Defense Active Duty/Reserve Forces Dental Examination, and submitted to the servicing dental clinic.

What is dental readiness class?

The Dental readiness classification is a simple descriptor for a patient's overall oral health. It is a cumulative figure representing all the patient's dental diagnoses and procedures. The dental classification is updated through treatment that has been performed or by a Type 2 examination during an open encounter.

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What is DD 2813?

DD 2813 is a Department of Defense (DoD) form used for reporting dental examinations and assessments for service members.

Who is required to file DD 2813?

Active duty service members and certain reserve members who undergo dental examinations are required to file DD 2813.

How to fill out DD 2813?

DD 2813 should be filled out by a dental care provider who conducts the examination, providing all relevant information including the service member's details, dental findings, and any recommendations.

What is the purpose of DD 2813?

The purpose of DD 2813 is to maintain a comprehensive record of a service member's dental health status which is used for readiness assessments and treatment planning.

What information must be reported on DD 2813?

Information that must be reported on DD 2813 includes the service member's name, Social Security number, dental examination findings, current dental status, and any necessary treatment recommendations.