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  • Dd 2792 2021

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INSTRUCTIONS FOR COMPLETING DD FORM 2792 FAMILY MEMBER MEDICAL SUMMARY GENERAL. The DD Form 2792 and attached addenda are completed to identify a family member with special medical needs. DD FORM 2792 INSTRUCTIONS AUG 2014 Items 10. a. - c. To be completed by the administrator in consultation with the family. DD FORM 2792 ADDENDUM 1 AUG 2014 1. DIAGNOSIS ES. Please complete as accurately as possible using ICD-9-CM or when approved ICD-10-CM. Parent/ guardian or person of majority age certifies that the information contained in the DD 2792 is correct. SPECIAL ASSIGNMENT CONSIDERATIONS X all that apply a. Possible Special Education/Early Intervention If checked DD Form 2792-1 must be completed b. NAME OF PATIENT SIGNATURE OF PATIENT/PARENT/GUARDIAN RELATIONSHIP TO PATIENT DATE YYYYMMDD DD FORM 2792 AUG 2014 PREVIOUS EDITION IS OBSOLETE. Page 1 of 11 Pages Adobe Designer 9. Military only. Item 6. a. If Yes complete b. - c. Self-explanatory. Item 7. Identify current medically necessary ada....

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Follow the steps to successfully complete the DD 2792 online.

  1. Click the ‘Get Form’ button to access the DD 2792 and open it in your preferred online editor.
  2. Begin filling out Section 1: Personal information. Here, enter the full name, date of birth, and contact details of the individual for whom the form is being filled out.
  3. Proceed to Section 2: Military information. Provide relevant details regarding the military affiliation, including branch, rank, and service status.
  4. Next, move to Section 3: Eligibility. This section requires you to confirm eligibility for services by selecting the appropriate responses.
  5. In Section 4: Family information, list information about family members as instructed, ensuring accuracy and completeness.
  6. Section 5 pertains to additional certifications. Complete any required certifications by providing requested information.
  7. Finally, review all sections for accuracy. Save your changes, then download, print, or share the completed DD 2792 as needed.

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DD Form 2792, "Family Member Medical Summary," August 2014 This form is used to document a family member's special medical needs and for enrollment in the Exceptional Family Member Program.

To view DOD Forms, Directives, and Instructions, visit the following link: https://www.esd.whs.mil/DD/. From this main page, click on the DOD Forms or DOD Issuances drop-down menus in the toolbar to search for a specific form, directive or instruction by issuance number or subject matter.

The Exceptional Family Member Program (EFMP) is a Department of Defense program designed to identify and document the special medical and/or educational needs of a soldier's family members and ensure that those needs are considered during the assignment process.

Family Member Prefix (FMP). Applies to Miliitary medical beneficiary only. The Family Member Prefix is assigned when the family member is enrolled in DEERS. ... The DBN can be found above the bar code on the back of the beneficiary's ID card.

IRS Withholding Certificate for Pension or Annuity Payments. DD 2656-10.

What is a DD Form 2058 and what is it used for? The DD Form 2058, State of Legal Residence Certificate, can be found in the Finance Office and is used by the Defense Finance and. Accounting Service (DFAS) to indicate that you have changed your domicile for military pay purposes.

Forms must be updated every three years or as your family status changes. To enroll or update in the EFMP, please do the following: Complete pages 1-3 of the Medical Summary DD Form 2792 (see forms below) and submit the entire document to a qualified medical professional who will complete pages 4-11.

To view DOD Forms, Directives, and Instructions, visit the following link: https://www.esd.whs.mil/DD/. From this main page, click on the DOD Forms or DOD Issuances drop-down menus in the toolbar to search for a specific form, directive or instruction by issuance number or subject matter.

PRINCIPAL Used to report items of information to individuals reporting for active duty. ... Information is used to report periods of active duty and physical condition upon entry and release from active duty.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232