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The Ahrc 56 R Form is a form that has been created by the American Health Care Association. The purpose of this form is to be able to fill out and report information from hospitals about patient care activities. This form is used in the United States, Canada, Mexico, and Costa Rica. It can also be completed electronically or manually with pen and paper. In order for hospitals to get paid it needs to have at least one signature from a licensed physician on it as well as an authorized signature from a hospital administrator if it was completed electronically.

In order to find out a handful of specific details in relation to the PDF you intend to use, here is the specifics you can study before filling in the ahrc 56 r form.

Question	Answer
Form Name	Ahrc 56 R Form
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	ahrc form 56 r, 56 r, ahrc form 3924, ahrc 56r

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PROMOTION QUALIFICATION STATEMENT

AUTHORITY: Title 10 U.S. Code, section 14308 and 14309. ROUTINE USES: To provide information on the promotion qualification of the officer, reconcile the data shown in the USAR Personnel Database with that on this form, and document review. EFFECT OF FAILURE TO PROVIDE REQUESTED INFORMATION: Disclosure is voluntary; however, failure to disclose the requested information may delay or prevent promotion.

SECTION I – SELECTED OFFICER’S PERSONAL DATA

NAME: (Last, First, MI)

LAST FOUR OF SSN: (***-**-####)

***-**-

BRANCH/PRIMARY AOC

CURRENT GRADE

CURRENT ORGANIZATION

TPU IRR

IMA

AGR

SECTION II – REVIEW BY OFFICER’S IMMEDIATE COMMANDER

1. Officer under suspension of favorable personnel action:

Yes

2.The following information concerns the officer’s position upon promotion or matched position (Mobilized Officers , Officers on Active Duty for Operational Support over 90 days) upon promotion:


2a. AUTHORIZED GRADE	2b.	AUTHORIZED BRANCH			2c. DUTY AOC

2d. UNIT OF ASSIGNMENT UPON PROMOTION	2e.	IS POSITION OCCUPIED BY ANOTHER			2f. UIC
	OFFICER?		YES	NO

2g. PARA/LINE

2h. POSITION NUMBER

2i. DATE ASSIGNED/MATCHED TO POSITION

3.The following information concerns the previous incumbent’s new position or new duty location. (AGR Only)

3a. NEW UIC

3b. NEW PARA/LINE

3c. NEW POSITION NUMBER

3d. REPORT DATE

3e. PREVIOUS POSITION DEPART DATE

4. Check one. Unit may only place AGR officers against valid Full Time Support (AGR) positions.

Is an AMEDD officer of either the Medical Corps or Dental Corps assigned to a position up to two grades to below the grade to which promoted to Chapter 4-9a (3)a, AR 135-155

Is a Chaplain or Judge Advocate General Corps Officer assigned to a position up to one grade below the grade to which promoted Chapter 4-9a (3)b, AR 135-155

Is a Chief Warrant Officer Five (CW5) Para/Line Position Number

5.This mobilized officer will be assigned to a position commensurate with the grade to which he or she is being promoted upon release from active duty (REFRAD), or reassigned to the IRR if the Officer cannot find an appropriate position within 180 days of the date of REFRAD.

6.For officers mobilized/deployed/ADOS provide a copy of the order.

__________________________

DATE OF MOBILIZATION

SECTION III – REVIEW BY OFFICER’S IMMEDIATE COMMANDER

7.I verify that the above information is correct and complete and that the Soldier is in a valid vacant position. No double slotting/overlap is authorized. I understand that falsifying official information may lead to UCMJ or other forms of disciplinary action taken against me.

GRADE AND NAME OF RSC/DRC REPRESENTATIVE

SIGNATURE OF RSC/DRC REPRESENTATIVE

UNIT NAME

UNIT UIC

EMAIL ADDRESS

DATE

AHRC FORM 56-R, SEP 2009

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Write down the expected details in the field Check one Unit may only place AGR, Is an AMEDD officer of either the, grades to below the grade to which, Is a Chaplain or Judge Advocate, below the grade to which promoted, Is a Chief Warrant Officer Five CW, This mobilized officer will be, For officers, DATE OF MOBILIZATION, SECTION III REVIEW BY OFFICERS, I verify that the above, GRADE AND NAME OF RSCDRC, SIGNATURE OF RSCDRC REPRESENTATIVE, UNIT NAME, and EMAIL ADDRESS.

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