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SIGNATURE OF PATIENT/PARENT/GUARDIAN RELATIONSHIP TO PATIENT DATE YYYYMMDD DD FORM 2792 AUG 2014 PREVIOUS EDITION IS OBSOLETE.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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How to fill out the DD 2792 online
This guide provides clear, step-by-step instructions for filling out the DD 2792 online. Whether you are new to digital document management or need a refresher, this guide aims to support you in completing the form efficiently.
Follow the steps to successfully complete the DD 2792 online.
- Click the ‘Get Form’ button to access the DD 2792 and open it in your preferred online editor.
- 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.
- Proceed to Section 2: Military information. Provide relevant details regarding the military affiliation, including branch, rank, and service status.
- Next, move to Section 3: Eligibility. This section requires you to confirm eligibility for services by selecting the appropriate responses.
- In Section 4: Family information, list information about family members as instructed, ensuring accuracy and completeness.
- Section 5 pertains to additional certifications. Complete any required certifications by providing requested information.
- Finally, review all sections for accuracy. Save your changes, then download, print, or share the completed DD 2792 as needed.
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What is a DD Form 2792?
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.
Where can I find DD Forms?
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.
Where can I get DD Forms?
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.
What is an Efmp screening?
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.
What is a family member prefix for Military?
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.
What is a DD Form 2656?
IRS Withholding Certificate for Pension or Annuity Payments. DD 2656-10.
Where can I get a DD Form 2058?
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.
How do I update Efmp?
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.
What is a DD 220?
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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