Get Dd Form 2870

Filling out the DD Form 2870 online is a crucial step for individuals seeking to authorize the release of their medical or dental information. This guide provides clear, step-by-step instructions to help users navigate the form efficiently and accurately.

Follow the steps to successfully complete the DD Form 2870 online.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by completing Section I - Patient Data. Input the patient's name, date of birth, and social security number in the designated fields.
3. For Block 4, state the treatment period using the format (YYYYMMDD) and ensure not to enter 'ONGOING' or 'ALL' for the treatment dates.
4. Indicate the type of treatment by selecting either outpatient, inpatient, or both in the corresponding checkbox.
5. In Section II, Block 6, specify the facility or TRICARE health plan authorized to release medical information, including the name, address, telephone, and fax numbers.
6. Mark the reason for the request in Block 7 by selecting all applicable options, including personal use, continued medical care, insurance, legal, or other with a specification.
7. In Block 8, write 'Any and all medical records' to describe the information to be released, and ensure it aligns with the treatment date provided in Block 4.
8. Enter the authorization start date in Block 9 using the format (YYYYMMDD), making sure it matches the dates used previously.
9. For Block 10, fill in the expiration date of the authorization, ensuring it does not exceed one year from the date in Block 9.
10. Finally, sign the form in Section III, enter the date in Block 13 using the (YYYYMMDD) format, and indicate your relationship to the patient if applicable.
11. Once all sections are fully completed, you can save your changes, download the filled form, print it, or share it as required.

Complete your documents online today for efficient health information management.