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Get DA 4465 2001-2024

ON I - IDENTIFICATION 2. PATIENT IDENTIFICATION 1. DATE ENROLLED/SCREENED (YYYYMMDD) 4. SERVICE AREA CODE 6. DEPARTMENT (Check one) 3. DATE OF BIRTH (YYYYMMDD) 5. NAME OF COMMUNITY COUNSELING CENTER 7. ELIGIBILITY CATEGORY (Check one) 8. CASE FINDING METHOD (Check one) a. BIO-CHEMICAL b. NON BIO-CHEMICAL A. Army A. Active Duty CI. F. Air Force N. Navy B. Active Duty for Training C. Cadet/Midshipman M. Marine D. Inactive Duty Training P. Coast Guard W. Public Health Svc. E. Retire.

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