Get Wounded Warrior Center Information Sheet - Woundedwarriorregiment

Filling out the Wounded Warrior Center Information Sheet is an essential process for assisting service members and their families in accessing necessary support services. This guide will walk you through each section of the form to ensure you provide accurate and comprehensive information.

Follow the steps to complete the Wounded Warrior Center Information Sheet online.

1. Click 'Get Form' button to access the form and open it in your preferred editor.
2. Begin by entering the date of request in the designated field. This establishes when the referral is made.
3. In the patient information section, provide the rank, full name, phone number, and date of injury. Indicate if the injury is combat-related by circling 'Yes' or 'No'.
4. Complete the unit information section, providing the unit name, point of contact (POC), phone number, and email address.
5. Fill out the provider's information, including their name, rank, phone number, and email. This identifies the healthcare provider responsible for the patient's care.
6. In the marine information section, enter the name, rank, marital status, and whether billeting is required. Indicate if any adaptive equipment or housing is necessary and provide details if applicable.
7. Answer the questions regarding the member’s diagnosis, care facility capabilities, estimated recovery period, and assigned medical specialties. Provide details for questions regarding limited duty, medical evaluations, and driving clearance.
8. Answer the series of questions regarding the member’s health history, including missed appointments, substance abuse, treatment experiences, and screenings for traumatic brain injury (TBI) or post-traumatic stress disorder (PTSD). Provide explanations where necessary.
9. Outline any specific medical needs, controlled medications, anticipated surgeries, and the medical plan of care.
10. Finally, provide additional information relevant to the recommendation for transfer to the Wounded Warrior Battalion.
11. Sign and date the document, ensuring that a medical officer stamp is included.
12. Once the form is completed, save changes, download the document, or print it for submission as required.

Complete your documentation online today to provide the necessary support for our wounded warriors.