Get Dod Mod 13 Tab C 2018-2025

The DoD MOD 13 TAB C is a vital form used for medical waiver requests within the CENTCOM operational framework. This guide provides comprehensive, step-by-step instructions on how to accurately complete the form online, ensuring that all necessary information is captured effectively.

Follow the steps to complete the form online.

1. Press the ‘Get Form’ button to obtain the document and view it in your browser.
2. Begin filling out the form with the patient’s name, ensuring you list the last name first, followed by the first name.
3. Enter the number of previous deployments the patient has had in the designated field.
4. Fill in the destination country where the deployment is planned or has occurred.
5. Indicate the patient's age in the appropriate section.
6. Specify the grade of the patient in the provided field.
7. Select the patient's sex in the corresponding area.
8. Provide the years of service of the patient in the specified box.
9. Input the last four digits of the patient's Social Security Number (SSN).
10. State the date of birth (DOB) of the patient accurately.
11. Describe the diagnosis using lay terminology to ensure clarity.
12. Specify the branch of service the patient is associated with: Active, Reserve, Guard or Civilian.
13. Indicate the length of the deployment in the corresponding section.
14. Respond to the question regarding previous waivers by selecting Yes or No.
15. Input the home station of the patient in the designated field.
16. Fill out the Military Occupational Specialty (MOS) or job description for the patient.
17. Indicate whether the patient is currently deployed by selecting Yes or No.
18. Provide the name, email, and phone number of the point of contact (POC) for the waiver.
19. Add a case summary as required by the provider, including any necessary clinical information and attach supporting medical documentation as needed.
20. Review the case summary and indicate your submission of the request by signing in the appropriate field.
21. Ensure that the commander approves by obtaining their signature in the designated space provided.
22. The CENTCOM surgeon or component surgeon will provide a response regarding waiver approval; ensure appropriate signatures and dates are recorded.
23. Once all sections are complete, save your changes, download, print, or share the finalized document as required.

Complete your documents online now for efficient processing.