Family Member Medical Summary DD Form 2792 Instructions
The DD Form 2792 is essential for identifying family members with special medical needs. It provides detailed guidelines for completion and submission to ensure proper evaluation. Understanding how to fill out this form is crucial for accessing the necessary medical services.
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How do I fill this out?
Filling out the DD Form 2792 involves understanding its sections clearly. Begin by gathering all necessary medical information before starting. Ensure that all required signatures are obtained after the form is completely filled out.
How to fill out the Family Member Medical Summary DD Form 2792 Instructions?
1
Read the instructions carefully to understand each section.
2
Gather the relevant medical information and necessary documents.
3
Fill out the form accurately, ensuring all fields are completed.
4
Obtain the required signatures from all applicable individuals.
5
Submit the completed form to the appropriate medical facility.
Who needs the Family Member Medical Summary DD Form 2792 Instructions?
1
Military service members – to document special medical needs of their family members.
2
Health care providers – for assessing eligibility of patients for services.
3
EFMP coordinators – to manage enrollment of family members needing special care.
4
Family members with special needs – to ensure they receive proper medical attention.
5
Civilian employees – who need to disclose family medical needs for service access.
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1
Download the DD Form 2792 from the website.
2
Open the form using PrintFriendly's PDF editor.
3
Fill in the necessary medical information as prompted.
4
Utilize the save function to store the completed form.
5
Share the PDF through email or other channels as needed.
What are the instructions for submitting this form?
Submit the completed DD Form 2792 via email to the appropriate military treatment facility or EFMP office. Include all necessary documentation and ensure it is signed by the required parties. For any questions regarding the submission process, contact the MTF directly for guidance.
What are the important dates for this form in 2024 and 2025?
For 2024 and 2025, be aware of the expiration date of OMB approval on 2023-09-30 and any updates in military medical policies that could affect the use of DD Form 2792.
What is the purpose of this form?
The purpose of the DD Form 2792 is to accurately document the special medical needs of family members. This information is crucial for sponsoring military personnel to ensure access to necessary medical services. Moreover, it supports the enrollment into the Exceptional Family Member Program (EFMP) and facilitates appropriate care and resource allocation.
Tell me about this form and its components and fields line-by-line.
- 1. Family Member / Patient Name: The full name of the family member needing medical evaluation.
- 2. Sponsor Name: The name of the military sponsor responsible for the family member.
- 3. DoD ID Number: A unique identifier assigned to the military sponsor.
- 4. Family Member Date of Birth: The birthdate of the family member requiring assessment.
- 5. Diagnosis: The medical diagnosis of the family member, including related codes.
- 6. Medications: A list of current medications being taken by the family member.
- 7. Treatment Plan: Details regarding proposed treatments for the specified conditions.
- 8. Provider Information: Contact information of the medical provider completing the form.
- 9. Signatures: Fields for the signatures of involved parties to certify the information.
What happens if I fail to submit this form?
Failure to submit the DD Form 2792 can lead to delays in accessing necessary medical services for the family member. It may also result in non-enrollment in the EFMP, creating barriers to essential support resources.
- Delayed Access to Services: Not submitting the form may delay crucial medical services for the family member.
- Non-Enrollment in EFMP: Failure to submit may result in the family member being ineligible for valuable programs.
- Missed Deadlines: Important deadlines for military assignments and healthcare evaluations may be missed.
- Inaccurate Records: Without submission, records may remain incomplete, complicating future care.
- Legal Implications: Legal responsibilities regarding dependency and healthcare may be compromised.
How do I know when to use this form?
- 1. EFMP Enrollment: Use this form to enroll family members in the Exceptional Family Member Program.
- 2. Medical Updates: Submit when there are changes in special medical needs or conditions.
- 3. Travel Requests: Utilized for requesting government-sponsored travel for affected family members.
- 4. Case Management: Necessary for ongoing case management services for family members.
- 5. Medical History Documentation: Documentation of medical history for review by medical personnel.
Frequently Asked Questions
What is the DD Form 2792?
The DD Form 2792 is a document used to assess and document the special medical needs of a family member.
Who needs to fill out this form?
This form is primarily filled out by military sponsors, family members, or authorized caregivers.
How do I edit this form?
You can use our PDF editor on PrintFriendly to add or change information in the DD Form 2792.
Can I sign the form online?
Yes, PrintFriendly offers a feature that allows you to digitally sign the form.
Is this form necessary for EFMP enrollment?
Yes, it's essential for enrolling a family member in the Exceptional Family Member Program (EFMP).
How do I submit the completed form?
You can submit the form via email to your EFMP office or military treatment facility.
Can I share this form with others?
Absolutely! PrintFriendly allows you to share the form through various channels.
What if I need to update the form later?
You can edit the form anytime using PrintFriendly and submit the updated version.
Where do I find additional support for this form?
For additional support, consult your healthcare provider or the EFMP office.
Do I need to fill out every section?
Yes, all applicable sections must be completed to ensure proper evaluation of medical needs.
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