Get Dd Form 877

Completing the DD Form 877 online is a straightforward process that allows you to request medical and dental records efficiently. This guide provides clear, step-by-step instructions to help you fill out the form accurately and submit it with confidence.

Follow the steps to complete the DD Form 877 online.

1. Click the ‘Get Form’ button to access the DD Form 877 and open it in the editing interface.
2. Begin by filling in the patient’s information. This includes the patient's last name, first name, and middle name in Item 1.
3. In Item 2, specify the organization and place of treatment for the patient.
4. Determine the patient's status in Item 3 by selecting from the provided options: military, VA beneficiary, or dependent.
5. If the patient is a dependent, enter the name of the sponsor in Item 3a.
6. Continue to Item 4 by including the full address, including the ZIP code, of where the request is directed.
7. Provide identifying information in Item 5, which includes the service number, grade/rate, social security account number, VA claim number, and date of birth if the patient is a federal employee.
8. In Item 6, specify the inclusive dates of treatment.
9. Item 7 requires you to state the disease or injury for which you are requesting records.
10. For Item 8, indicate the records requested by checking the appropriate boxes.
11. If applicable, provide additional remarks in Item 9.
12. Sign the form in Item 10 to validate your request.
13. Complete the referral information in Items 11 to 18 if required, addressing any additional comments or follow-up notes.
14. Finally, ensure that Item 19 is filled out with a complete address and ZIP code where records or replies should be sent.
15. After completing the form, save your changes, download a copy, or print/prepare it for sharing as needed.

Start your request for medical or dental records by completing the DD Form 877 online today.