Dd2870 instructions Form 2023-2024

Dd2870 instructions Form: What You Should Know

Army, DOD, or hospital to make disclosure of any information that the applicant has or will have related to his or her service. The authorized personnel may access your medical, dental, or other records for the limited purpose of determining whether to disclose the relevant information to the service. For a copy of this information, please contact the Army Health System Public Affairs Office at: or via e-mail from the following address : AHS Public Affairs Branch (Private) If you are requesting copies of records, include a statement on the application form that the requested information should be made confidential. Incomplete applications will not be accepted. When you have completed the DD Form 2870 (i.e., filled out the boxes with your name, date of birth, address, and your signature), fill out another DD Form 2870, Authorization to Disclose Medical or Dental Information. When you authorize or agree to the disclosure, you will be notified in writing. You may request a copy of the disclosure notice by writing to the Army Health System Public Affairs Office at: Public Affairs Branch (Private) and follow the directions printed on the disclosure forms. When you are complete, mail the DD Form 2870 back to the Army Health System Public Affairs Office at: P. O. Box 1550, Washington, DC 20521. DO NOT Make BY THE NINTH SERVICE CORPS DOCTOR, NOR BY PROFESSIONAL PRACTITIONERS. Instructions and Explanation — DD Form 2870 What To Do If The Record Contains Personal Information When a record contains personal information, please contact your command Public Affairs office for the details, as needed. Identification of information obtained by the hospital from the hospital is limited to the information listed in these paragraphs. Patient's Title. The title and telephone number of the hospital are displayed directly on the hospital record. All personal information such as name, address, etc., is identified by the Department's public form, Identifiers for Personal Information, which you will obtain from your commanding officer. Name In General, Hospital Name and Address. The name and address of the hospital (in the form of a ZIP Code if applicable) in the form of an address if applicable. Medical Status. Indicate whether the patient has been hospitalized for any length of time. Diabetes.

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