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The DD Form 2766C serves as a vital tool within military medical records, capturing essential health information for service members. This form ensures continuity of care by providing critical details regarding medical history, allergies, and current medications. As a part of the medical record documentation process, it is instrumental for medical personnel to understand an individual's health status quickly. Additionally, the DD Form 2766C facilitates better communication during patient transfers and deployments, thereby enhancing patient safety and care consistency. The comprehensive nature of this form covers all necessary aspects, from previous treatments to significant health events. Its versatility and ease of use make it an indispensable asset for both healthcare providers and military personnel alike. Accessible and straightforward, the DD Form 2766C is approved for public release, ensuring that its critical data can be effectively utilized by authorized individuals.

Dd 2766C Example

Report Documentation Page

 

Report Date

 

Report Type

 

Dates Covered (from... to)

 

 

26 Mar 2001

 

N/A

-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Title and Subtitle

 

 

Contract Number

 

 

The Use of DD Form 2766 and DD Form 2766C

 

 

 

 

 

Grant Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Program Element Number

 

 

 

 

 

 

 

 

Author(s)

 

 

Project Number

 

 

 

 

 

 

 

 

 

 

 

 

 

Task Number

 

 

 

 

 

 

 

 

 

 

 

 

 

Work Unit Number

 

 

 

 

 

 

 

Performing Organization Name(s) and Address(es)

 

Performing Organization Report Number

 

 

Department of the Army Washington, DC 20310

 

 

 

 

 

 

 

 

 

Sponsoring/Monitoring Agency Name(s) and

 

Sponsor/Monitor’s Acronym(s)

 

 

Address(es)

 

 

 

 

 

 

 

Sponsor/Monitor’s Report Number(s)

 

 

 

 

 

 

 

 

 

 

 

 

 

Distribution/Availability Statement

 

 

 

 

Approved for public release, distribution unlimited

 

 

 

 

 

 

 

 

 

 

Supplementary Notes

 

 

 

 

 

 

 

 

 

 

 

Abstract

 

 

 

 

 

 

 

 

 

 

 

Subject Terms

 

 

 

 

 

 

 

 

 

 

 

Report Classification

 

 

Classification of this page

 

 

unclassified

 

 

unclassified

 

 

 

 

 

 

 

 

Classification of Abstract

 

 

Limitation of Abstract

 

 

unclassified

 

 

UU

 

 

 

 

 

 

 

 

Number of Pages 6

Form Characteristics

Fact Name Description
Form Purpose The DD Form 2766C is used to document military personnel's health history, particularly for deployment-related medical assessments.
Usage This form serves both as an individual health record and a planning tool for medical care and evacuation in military operations.
Report Date The report documentation page shows the report date as March 26, 2001.
Classification Status All content in the DD Form 2766C is classified as unclassified, meaning it can be shared freely within appropriate contexts.
Number of Pages The form consists of a total of six pages, covering various aspects of health documentation and guidelines.
Performing Organization The Department of the Army, located in Washington, DC, is responsible for the form's creation and maintenance.
Distribution Statement The form is approved for public release, indicating its availability for distribution without restrictions.
Supplementary Notes The report may include additional notes or comments that provide further context or clarification regarding its contents.
Related Forms DD Form 2766 is associated with the DD Form 2766C, providing a comprehensive health record for military personnel.

Guidelines on Utilizing Dd 2766C

The DD 2766C form is a key document used within military healthcare systems. Completing this form accurately ensures that important medical information is effectively communicated. Follow these steps to fill out the form correctly.

  1. Obtain the Form: Access the DD 2766C form from the appropriate military resources, either online or through your healthcare provider.
  2. Report Information: Begin by entering the report date and report type at the top of the form. Fill in the date which should reflect when you are completing the form.
  3. Enter Dates Covered: Indicate the time period that the information pertains to by entering the start and end dates in the section labeled "Dates Covered." Ensure that this is accurate and complete.
  4. Title and Subtitle: Fill in the title of the document as well as the subtitle if applicable. This should reflect the context of your medical information.
  5. Contract and Grant Numbers: If relevant, enter any contract number and grant number related to your medical service or program. If there is none, you can leave this section blank.
  6. Program Element Number: Write in the program element number, if applicable. This identifies the specific program of the military healthcare services.
  7. Author(s): List the name(s) of the individual(s) responsible for the content of the DD 2766C form. This typically includes healthcare professionals.
  8. Project and Task Numbers: Document any project number and task number associated with your medical records at the bottom of this section.
  9. Performing Organization: Enter the name and address of the organization providing the medical services. This can include hospitals or military clinics.
  10. Sponsoring/Monitoring Agency: Provide the name and acronym of any sponsoring or monitoring agency involved in your medical service.
  11. Distribution Statement: Indicate the distribution or availability statement. This often reflects the public release status, which is likely "approved for public release, distribution unlimited."
  12. Classification Information: Fill in the classification details. State whether the content is classified or unclassified, including any limitations on the abstract.
  13. Final Review: Review the entire form to ensure all information is complete and accurate before submission.

After completing the DD 2766C form, ensure that it is submitted to the appropriate military healthcare provider or organization as per the established protocol. This will facilitate the correct handling and processing of your medical information.

What You Should Know About This Form

What is the DD Form 2766C?

The DD Form 2766C, also known as the "Adult Preventive and Chronic Care Flowsheet," is a standardized medical form used by the military. It provides a succinct record of a service member’s health care history, including preventive and chronic care management. This form is crucial for ensuring continuity of care across different military medical facilities.

Who needs to use the DD Form 2766C?

The DD Form 2766C is primarily used by active-duty service members, reservists, and veterans receiving medical care through military health facilities. Healthcare providers utilize this form to efficiently track a patient’s health history, ensuring necessary information is readily available during medical evaluations and treatments.

How does the DD Form 2766C benefit service members?

This form offers several benefits, including streamlined communication among healthcare providers and a consolidated view of a service member’s health status. By having a comprehensive overview of medical history, it aids in optimal decision-making during treatment plans and reduces the risk of miscommunication regarding care needs.

When should the DD Form 2766C be updated?

Service members should update the DD Form 2766C whenever there are significant changes in their health status, such as the diagnosis of a new chronic condition, changes in medications, or completion of preventive care screenings. Regular updates help maintain an accurate medical record.

Where can service members access the DD Form 2766C?

The DD Form 2766C can typically be accessed through military health care facilities. Additionally, it is available online through various military resource websites, making it convenient for service members to print and complete as needed.

Is the information on the DD Form 2766C confidential?

Yes, the information contained in the DD Form 2766C is considered confidential. It is protected under military privacy regulations and policies. Unauthorized access to or distribution of this information can result in disciplinary actions.

Can family members view a service member's DD Form 2766C?

Access to a service member’s DD Form 2766C is typically restricted to the individual and their healthcare providers. Family members may only view the information with the service member’s consent, in line with health privacy regulations.

How is the DD Form 2766C different from the DD Form 2766?

The DD Form 2766 is a general Health Record for military personnel, while the DD Form 2766C is a specific flowsheet that focuses on adult preventive and chronic care. The latter provides a more detailed overview of ongoing and preventive health care needs, whereas the former tracks broader medical records.

Common mistakes

Filling out the DD Form 2766C can be straightforward, but many people make mistakes that can lead to confusion or delays. One common error is failing to provide complete personal information. This form is designed to capture vital details about a service member's medical history, so leaving out information like a correct Social Security number or address can cause issues later.

Another frequent mistake is not following the instructions for each section. Some people skip important parts or misinterpret what is required. Making sure to read the directions carefully can prevent misunderstandings and ensure that all necessary information is included.

Additionally, using incorrect dates can create complications. The form may ask for various date ranges, such as dates of service or previous medical treatments. Inaccurate dates can lead to confusion in medical records and continuity of care. It's essential to double-check these details before submitting the form.

People also sometimes forget to sign and date the form. The DD 2766C requires a signature to validate the information provided. Without this, the form may be considered incomplete, leading to delays in processing. A quick review before submission is always wise.

Furthermore, some individuals may not provide sufficient details about medical conditions or treatments. Listing only vague information can hinder healthcare professionals' understanding of a person's medical history. It’s crucial to be as specific as possible when describing past treatments and ongoing conditions.

Lastly, taking too much time to complete the form can be problematic. While it's important to be thorough, procrastination can lead to missed deadlines or rushed submissions. A balanced approach, ensuring the form is filled out carefully yet promptly, will help avoid these pitfalls.

Documents used along the form

The DD Form 2766C, often utilized in military medical settings, assists healthcare providers in managing the health care needs of service members. Along with this form, several other documents may facilitate a comprehensive understanding of a service member's health status and medical history. Below is a list of commonly associated forms and documents.

  • DD Form 2766: This document serves as a summary of significant medical history. It provides pertinent information regarding allergies, medications, and other health-related factors that may affect service members during missions or deployments.
  • SF 600 (Chronological Record of Medical Care): This form is a comprehensive record of medical evaluations and treatments that service members receive over time. It helps track ongoing health issues and treatments applied.
  • DD Form 1289: Known as the "Drug Record," this form documents prescriptions for service members. It ensures that all medications are tracked accurately and assists in preventing potential drug interactions.
  • DD Form 214: This document serves as a certificate of release or discharge from active duty. It contains essential information about a service member’s military service history, including medical conditions encountered during service.
  • SF 88 (Report of Medical Examination): This form is used to record the results of a medical examination. It includes findings relevant to the overall health status and fitness for duty of the service member.
  • SF 93 (Report of Medical History): This document complements the SF 88 by providing a detailed account of the service member's medical history, including past illnesses, surgeries, and conditions.
  • DD Form 2766-1: This form serves as an attachment to the DD Form 2766. It provides additional clinical information or updates about a service member's health that might not fit on the main form.
  • DA Form 3349 (Physical profile): This document outlines any physical limitations of a service member, specifically detailing conditions that may affect their ability to perform certain duties.
  • DD Form 577 (Appointment/Termination Record)**: This form appoints or terminates an individual in a specific position, which can include medical roles that impact healthcare delivery within military settings.
  • VA Form 10-10EZ (Application for Health Benefits): This form is used by veterans to apply for health care benefits through the Department of Veterans Affairs. It is essential for transition to civilian healthcare services.

These documents collectively ensure that healthcare providers have thorough and accurate information about a service member's medical history. By utilizing these forms, military healthcare practitioners can effectively address and manage various health concerns associated with military service.

Similar forms

The DD Form 2766C is a significant document within military healthcare that consolidates essential health information for service members. Similar documents serve various purposes in documenting and managing health-related information and may offer distinct functionalities. Below is a list of seven documents that share similarities with the DD Form 2766C.

  • DD Form 2766: This form is the predecessor to the DD Form 2766C, capturing essential health data that enables healthcare providers to deliver continuous care for military personnel.
  • SF 600 (Chronological Record of Medical Care): This form provides a chronological log of medical visits and procedures, allowing providers to track healthcare history over time.
  • DA Form 3349 (Medical Condition - Physical Profile Record): Used to describe a soldier's medical profile, this form details any physical limitations and restrictions based on health conditions, similar to the DD Form 2766C’s assessment of health readiness.
  • DA Form 4036 (Application for U.S. Army Registration): This document is used to maintain records pertinent to Soldier assignments and health, similar to how the DD Form 2766C compiles health information for decision-making.
  • ID Card/DEERS Registration (DD Form 1172): This registration streamlines access to medical benefits and services, acting alongside the DD Form 2766C in ensuring service members receive necessary care.
  • VA Form 21-526EZ (Application for Disability Compensation and Related Compensation Benefits): This form captures claims for health issues related to military service, highlighting the ongoing relationship between documented health and benefits such as those outlined in the DD Form 2766C.
  • DD Form 2870 (Authorization for Disclosure of Medical or Dental Information): This form allows service members to authorize the release of their medical records, maintaining accurate communication regarding their health status akin to the information compiled in the DD Form 2766C.

Dos and Don'ts

When filling out the DD 2766C form, attention to detail is crucial. Here’s a list of ten key do’s and don’ts to guide you through the process.

  • Do read the instructions carefully before starting to ensure you understand what is required.
  • Don't skip any sections or leave blank fields; this could delay the processing of your form.
  • Do use clear and legible handwriting or type your responses to avoid misinterpretation.
  • Don't use abbreviations that might not be universally understood; clarity is paramount.
  • Do double-check all information for accuracy, especially dates and identification numbers.
  • Don't provide personal information that is not requested; confidentiality is important.
  • Do ensure that any changes are initialed and dated to maintain a clear record.
  • Don't forget to review the classification statements to ensure compliance with confidentiality guidelines.
  • Do submit the form to the appropriate authority to prevent any delays in processing.
  • Don't neglect to keep a copy of the completed form for your records; documentation is key.

Following these guidelines can make the process smoother and more efficient. Each step has its importance in ensuring the form is filled out correctly, supporting your overall goals. Take your time, and don’t hesitate to ask for assistance if needed.

Misconceptions

Understanding the DD Form 2766C is crucial for many involved in military health care. However, several misconceptions can lead to confusion about its purpose and use. Here are four common misunderstandings:

  • The DD Form 2766C is only for service members. This form is also applicable to dependents and certain veterans. It serves as a health record summary for anyone seeking care in military facilities, not just active duty personnel.
  • Completion of the DD Form 2766C is optional. While it might feel informal, completing the DD Form 2766C is indeed an essential step for ensuring that health care providers have access to necessary medical information. It enhances coordination of care and continuity during visits.
  • The DD Form 2766C contains only basic medical information. In reality, this form encompasses comprehensive details, including medication histories, allergies, and significant medical procedures. Its thoroughness is critical for informed decision-making in medical situations.
  • Once submitted, the information on the DD Form 2766C is permanent. This is misleading. The form can and should be updated regularly. Changes in health status or medication can occur, necessitating revisions to ensure accuracy and relevance.

Key takeaways

When dealing with the DD Form 2766C, there are several important points to keep in mind. This form is essential for managing and documenting medical information, particularly for servicemen and servicewomen. Understanding its usage can significantly improve the overall quality of medical care received.

  • Purpose: The DD Form 2766C is designed to compile and summarize an individual’s medical history and health needs. It serves as a critical tool for healthcare providers in understanding the specific health concerns of military personnel.
  • Accuracy is Key: It is vital to fill out the form accurately and completely. Missing or incorrect information can lead to delays in treatment and misunderstandings regarding medical needs.
  • Regular Updates: Keep your DD Form 2766C updated. Changes in medical history, new treatments, or recent diagnoses should be reflected on this form to ensure that your healthcare providers have the most current information.
  • Accessibility: Always carry a copy of your DD Form 2766C when seeking medical care. Having this document readily available can expedite the process of receiving the appropriate and necessary medical attention.