U.S. DOD Form dod-af-af-1466d DENTAL HEALTH SUMMARY To be completed by dental provider This Form is subject to the Privacy Act of 1974 USE BLANKET PAS DD FORM 2005 PRINCIPAL PURPOSE An assessment by a dentist is needed to determine your dental health as part of the family member relocation clearance for travel. If you are enrolled in the TRICARE Dental Plan your civilian dentist completes this form. If you are not enrolled in the TRICARE Dental.
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How to fill out the Af Form 1466d online
Filling out the Af Form 1466d online is a critical step in assessing dental health for military family members. This guide provides detailed instructions to help users complete the form accurately and efficiently.
Follow the steps to complete the Af Form 1466d successfully.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- In section 1a, enter the patient’s name using last name, first name, and middle initial as applicable. In section 1b, input the sponsor's Social Security number and in section 1c, specify the family member prefix.
- In section 2, dental providers must assess the dental health status. Select the appropriate option that best describes the patient's condition by marking the corresponding block. Ensure to use a clinical examination with mirror and probe, and any necessary radiographs as indicated.
- If the patient's condition falls under block (3) or (4), circle the described conditions or briefly summarize recommended treatments. Provide clarity to enable understanding of the dental needs.
- Indicate whether x-rays were consulted in section 4. Clearly select 'Yes' or 'No' and provide the date if applicable, in the specified format (YYYYMMDD).
- Finally, in section 5, include the dental provider's name in 5a and ensure to sign in 5b, along with dating the form in 5c using the format (YYYYMMDD).
- After filling out all required sections, save your changes and consider downloading, printing, or sharing the completed form as directed.
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