Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Uncategorized Forms
  • 2173 Army

Get 2173 Army

1. NAME OF INDIVIDUAL EXAMINED (Last, First, and Middle Initial) 4. ORGANIZATION AND STATION 2. SSN 5. a. DATE 3. GRADE ACCIDENT INFORMATION b. PLACE (City and State) SECTION I - TO BE COMPLETED BY ATTENDING PHYSICIAN OR HOSPITAL PATIENT ADMINISTRATOR 6. INDIVIDUAL WAS OUT PATIENT ADMITTED DEAD ON ARRIVAL 8. HOUR AND DATE ADMITTED 10. NATURE AND EXTENT OF 11. MEDICAL OPINION: b. INJURY INJURY a. INDIVIDUAL INDIVIDUAL c. d. INJURY WAS IS WAS CIVILIAN 7. NAME OF HOSPITAL OR TREATMENT.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the 2173 Army online

The 2173 Army form, also known as the Statement of Medical Examination and Duty Status, is vital for documenting a person's medical examination and duty status within the military. This guide provides clear, step-by-step instructions to help you complete the form accurately and effectively.

Follow the steps to successfully complete the 2173 Army form.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering the name of the individual examined, including their last name, first name, and middle initial in section 1. This information is crucial for proper identification.
  3. In section 2, fill in the individual's social security number (SSN) to ensure accuracy in records. Proceed to section 3 to indicate the grade of the individual.
  4. For accident information, complete section 4 by providing the organization and station of the individual. Ensure all information is accurate.
  5. Section I is to be completed by the attending physician or hospital patient administrator. Fill out sections 6 through 12 regarding the individual's medical status, including the nature and extent of the injury, any relevant medical opinions, and other essential details.
  6. Under accident details, section 15 requires a thorough explanation of how, where, and when the incident occurred. This information is pertinent for understanding the circumstances surrounding the case.
  7. Section II is designated for the unit commander or unit adviser’s input. Complete sections 19 through 34, which reflects the individual’s duty status and any required remarks related to absences from duty.
  8. After ensuring all sections are filled out correctly, review the form for accuracy. You can then save your changes, download, print, or share the completed form as needed.

Take the next step and complete your 2173 Army form online today.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

Line of Duty Determination FAQ - ccmis
Jun 16, 2022 — A LOD determination is an informal or formal investigation to determine...
Learn more
Army Regulations 40-400: Medical Services
DA Form 2173 (Statement of Medical Examination and Duty Status). (3) A description of the...
Learn more
Aeroquip Performance Products
AN (Army-Navy). The AN (Army-Navy) standard was established many years ago by the U.S...
Learn more

Related links form

Practice Eligibility Route To Certification For Specialist - Royal College Questionnaire For Request Of Army Band Performance Medical Telephone Message Template Declarative Imperative Interrogative Or Exclamatory - Cpatc

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

To check your board file in the Army, you should start by contacting your unit's personnel office for guidance on accessing your records. They can provide information on any necessary steps or forms required for you to review your file. Understanding this process is essential for any service member involved with the 2173 Army, as it ensures you stay informed about your standing and any related matters.

Starting a line of duty investigation in the Army begins with notifying your chain of command about the incident. They will initiate the process and assign personnel to collect statements and evidence. It is essential to have your DA Form 2173 complete, as this form supports your case during the review of your line of duty status in the 2173 Army.

The Army Lod form generally refers to the documentation related to the line of duty determination process, primarily the DA form 2173. This form outlines the circumstances of an injury or illness experienced by a soldier while on duty. Understanding its use is important for protecting a soldier’s rights and entitlements within the Army.

A 2173 refers specifically to the DA form 2173, which documents incidents involving injuries or illnesses in the Army. This form is crucial for verifying whether such incidents occurred in the line of duty, which can determine a soldier’s access to benefits and support. It's a standard form that every soldier should familiarize themselves with.

The Lod program is designed for active-duty soldiers who experience injuries or illnesses that need to be evaluated for line of duty determination. This program ensures that service members receive the appropriate medical care and benefits related to their injuries. Engaging with the Lod program through the proper forms like the 2173 Army is essential for these soldiers.

The DA-6 is a form used by the Army for documenting and tracking an individual soldier's line of duty status. It serves as a continuation or supplementary document to the DA form 2173. Understanding the differences between these forms is essential for properly managing a soldier's medical and duty status during their service.

To fill out a par army document, start by identifying the necessary sections that require your information. Ensure you provide accurate details regarding your situation, such as dates and reasons for the request. Keeping clarity in your entries will facilitate the processing of your form. If you need guidance, you can explore resources available on the US Legal Forms platform.

To obtain a line of duty (LOD) in the army, you must file DA Form 2173 as soon as possible after the incident. Ensure you gather witnesses and all relevant details regarding the situation. The 2173 Army process involves submission and review, so utilizing a structured approach through services like uslegalforms can significantly ease this task.

A line of duty determination is generally required when a soldier faces injury or illness that affects their ability to serve. It is crucial for ensuring the soldier receives appropriate benefits and assistance. Familiarize yourself with the 2173 Army guidelines to understand when to initiate this process and what documentation is necessary.

When filling out a leave form, start by providing accurate personal details, including your rank and unit. Next, specify the dates for your requested leave and the purpose. Understanding the formal requirements through resources or guides dedicated to 2173 Army processes can help streamline your leave application.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get 2173 Army
Get form
  • Adoption
  • Bankruptcy
  • Contractors
  • Divorce
  • Home Sales
  • Employment
  • Identity Theft
  • Incorporation
  • Landlord Tenant
  • Living Trust
  • Name Change
  • Personal Planning
  • Small Business
  • Wills & Estates
  • Packages A-Z
  • Affidavits
  • Bankruptcy
  • Bill of Sale
  • Corporate - LLC
  • Divorce
  • Employment
  • Identity Theft
  • Internet Technology
  • Landlord Tenant
  • Living Wills
  • Name Change
  • Power of Attorney
  • Real Estate
  • Small Estates
  • Wills
  • All Forms
  • Forms A-Z
  • Form Library
  • Legal Hub
  • About Us
  • Help Portal
  • Legal Resources
  • Blog
  • Affiliates
  • Contact Us
  • Delete My Account
  • Site Map
  • Industries
  • Forms in Spanish
  • Localized Forms
  • State-specific Forms
  • Forms Kit
  • Real Estate Handbook
  • All Guides
  • Notarize
  • Incorporation services
  • For Consumers
  • For Small Business
  • For Attorneys
  • USLegal
  • FormsPass
  • pdfFiller
  • signNow
  • altaFlow
  • DocHub
  • Instapage
Form Packages
  • Adoption
  • Bankruptcy
  • Contractors
  • Divorce
  • Home Sales
  • Employment
  • Identity Theft
  • Incorporation
  • Landlord Tenant
  • Living Trust
  • Name Change
  • Personal Planning
  • Small Business
  • Wills & Estates
  • Packages A-Z
Form Categories
  • Affidavits
  • Bankruptcy
  • Bill of Sale
  • Corporate - LLC
  • Divorce
  • Employment
  • Identity Theft
  • Internet Technology
  • Landlord Tenant
  • Living Wills
  • Name Change
  • Power of Attorney
  • Real Estate
  • Small Estates
  • Wills
  • All Forms
  • Forms A-Z
  • Form Library
Customer Service
  • Legal Hub
  • About Us
  • Help Portal
  • Legal Resources
  • Blog
  • Affiliates
  • Contact Us
  • Delete My Account
  • Site Map
  • Industries
  • Forms in Spanish
  • Localized Forms
  • State-specific Forms
  • Forms Kit
Legal Guides
  • Real Estate Handbook
  • All Guides
Prepared for you
  • Notarize
  • Incorporation services
Our Customers
  • For Consumers
  • For Small Business
  • For Attorneys
Our Sites
  • USLegal
  • FormsPass
  • pdfFiller
  • signNow
  • altaFlow
  • DocHub
  • Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
© Copyright 1999-2026 airSlate Legal Forms, Inc. 3720 Flowood Dr, Flowood, Mississippi 39232
  • Your Privacy Choices
  • Terms of Service
  • Privacy Notice
  • Content Takedown Policy
  • Bug Bounty Program