Get Dod Form Dod-dd-2854

Filling out the DOD Form dod-dd-2854 can be straightforward when you follow the proper guidelines. This form is essential for individuals seeking to disenroll from the TRICARE Plus program, and ensuring accuracy in your submission is crucial for the processing of your request.

Follow the steps to complete the DOD Form dod-dd-2854 online.

1. Click the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Section I requires sponsor information. Enter the sponsor's Social Security Number, full name (last, first, middle initial), and date of birth in the requested format (YYYYMMDD). Ensure this information matches your Defense Enrollment Eligibility Reporting System records.
3. In Section II, list the individuals requesting disenrollment. For each person, provide their full name, date of birth (YYYYMMDD), and select the reason for disenrollment by marking the appropriate box. If applicable, choose 'Other' and provide a brief explanation.
4. For each individual, fill in the requested disenrollment date and provide a valid telephone number, including the area code. Make sure to include both home and work numbers where applicable.
5. In Section III, the individual completing the form must sign and date the application, certifying that all provided information is accurate and complete.
6. After completing the form, ensure you keep a copy for your records. Submit the completed application to the Military Treatment Facility where you are currently enrolled.

Take action now and complete your DOD Form dod-dd-2854 online for efficient management of your disenrollment request.