DA Form 5841 PDF Details

You should show this POA or other documentation to all facilities, institutions, and individuals to ensure they will recognize it for the purposes you have intended.

Health care: doctors, dentists, and hospital officials or other health care providers who may be called upon to treat your child(ren).

Schools: any school officials or other officials who may need your permission to provide services for your child (ren) or register your child(ren) in school.

Custody: a POA will not prevent a non-custodial parent or relative of your child(ren) from petitioning a court to obtain temporary or permanent custody.

QuestionAnswer
Form NameDA Form 5841
Form Length3 pages
Fillable?Yes
Fillable fields25
Avg. time to fill out5 min
EditionJUL 2020
Proponent agencyDCS, G-1 (AR 600-20)
Previous editionsObsolete
Other namesDA Form 5841, DA 5841, DA5841, Form 5841, Army 5841, Power of Attorney
Official sourceDA Form 5841 (Rev JUL 2020), DCS, G-1

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