Get Dd Form 877

Filling out the Dd Form 877, Request for Medical/Dental Records or Information, is a straightforward process that can be completed online. This guide provides step-by-step instructions to assist you in accurately completing and submitting the form.

Follow the steps to successfully complete the Dd Form 877 online.

1. Click 'Get Form' button to access the Dd Form 877 and open it in your preferred editing tool.
2. Begin by filling out the patient information in Item 1. Provide the last name, first name, and middle name of the individual requesting the records.
3. In Item 2, specify the organization and place of treatment. This ensures that the records can be accurately retrieved.
4. Complete Item 3a if the person requesting the records is a dependent, entering the name of the sponsor.
5. For Item 4, write the address to which the records should be sent, including the ZIP code.
6. Fill out the identifying information in Item 5, including the service number, grade/rate, social security account number, VA claim number, and date of birth if applicable.
7. In Item 6, indicate the dates of treatment for which you are requesting records.
8. Item 7 requires you to specify the disease or injury related to the requested records.
9. For Item 8, check the appropriate boxes for the types of records requested, clarifying your needs.
10. In Item 9, you may add any remarks that could assist in processing the request.
11. Complete Item 10 with your signature to validate the request.
12. Proceed to Items 11 to 18 for any necessary referrals or replies, providing signatures and dates as required.
13. Finally, ensure that Item 19 has the complete return address to which the records or final reply should be mailed.
14. After thoroughly reviewing your entries, save the changes, and proceed to download or print the completed form.

Get started on completing the Dd Form 877 online today!