Get Dd Form 2161

Completing the Dd Form 2161 is an essential step for accessing civilian medical care when services are unavailable at military facilities. This guide provides clear and comprehensive instructions for filling out the form online to ensure a smooth process.

Follow the steps to complete the Dd Form 2161 online.

1. Press the ‘Get Form’ button to access the Dd Form 2161 and open it in your preferred document editor.
2. Enter the request details in the 'FROM' section, including the requesting physician or activity's name.
3. In the 'TO' section, specify the medical facility that will receive the consultation request.
4. Fill in the 'DATE OF REQUEST' field with the current date.
5. Document the 'REASON FOR REQUEST' by describing the patient's complaints and findings.
6. Anticipate and note the 'ANTICIPATED LENGTH OF TREATMENT' based on the physician's assessment.
7. Provide the 'PROVISIONAL DIAGNOSIS' as determined by the requesting physician.
8. Obtain the requesting physician's approval by having them sign in the 'DOCTOR’S SIGNATURE' space.
9. Select the 'PLACE OF CONSULTATION' by checking the appropriate box for bedside, on call, routine, today, 72 hours, or emergency.
10. Complete the 'CONSULTATION REPORT' information, including the signatures required from the identification number and organization.
11. Fill out the patient’s identification details, including their name, grade, rank, and the medical facility.
12. Have the patient or responsible family member sign in the 'PATIENT/RESPONSIBLE FAMILY MEMBER SIGNATURE' section.
13. Include the sponsor’s full social security account number (SSAN) and registration number.
14. Check other applicable sections and ensure all information is correct before saving your changes.
15. Download, print, or share the completed form as needed for submission to the appropriate organization.

Complete your Dd Form 2161 online today for efficient access to necessary medical services.