The DA Form 8003 serves as a critical document within the Army Substance Abuse Program (ASAP), outlining a structured process for enrolling individuals who may require assistance with substance use issues. This form acts as a first step, ensuring that anyone who is potentially struggling can be quickly and thoroughly assessed to determine the need for further intervention. Key sections of the form include personal identification details such as name, rank or grade, and service number, as well as specifics about the type of referral—whether it emerged from self-identification, command direction, medical advice, or other circumstances. It also delves into the individual's history of substance use, criminal convictions, and performance evaluations, aiming to paint a complete picture of the situation. The form prompts for detailed reasons behind the referral, encouraging the reporting of any physical signs, personality changes, or other behavioral indicators that suggest a substance misuse problem. This comprehensive approach not only helps to identify those in need of support but also tailors the subsequent steps of intervention, education, or rehabilitation that are deemed appropriate. DA Form 8003 underscores the military's commitment to the welfare of its members, highlighting the processes in place to assist individuals in overcoming challenges related to substance use, thereby ensuring their readiness and effectiveness.
| Question | Answer |
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| Form Name | Da Form 8003 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | grade 8003 91, command form da, program use asap, defensiveness enrollment |
ARMY SUBSTANCE ABUSE PROGRAM (ASAP) ENROLLMENT
For use of this form, see AR
The person named below is being referred to the ASAP for a comprehensive assessment to determine whether or not the individual meets the criteria for enrollment.
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Name (Last, First, MI). |
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Rank/Grade. |
3. SSN. |
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DOB (YYYYMMDD) |
5. Yrs Act/Fed Svc. |
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Is Servicemember/Employee |
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Is Servicemember/Employee |
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Is Servicemember/Employee |
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expected to depart installation |
on flying status? |
involved in Personnel Reliability |
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within 90 days? |
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Program? |
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YES NO
YES NO
YES NO
9. Type of Referral: Biochemical |
(Type Drug) |
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Self |
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Command |
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Supervisor |
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Investigation/Apprehension |
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Medical |
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Other |
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10.Record of Civilian Arrests/Convictions, Courts Martial, Company Punishments, and Disciplinary Problems, including those Pending: (Specific dates and offenses)
11.Performance: (Give specifics of fair or unsatisfactory ratings)
Performance/ |
Efficiency: |
Excellent |
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Good |
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Fair |
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Unsatisfactory |
Behavioral/ |
Conduct: |
Excellent |
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Good |
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Fair |
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Unsatisfactory |
12.Reasons for Referral: (Check appropriate spaces)
a. Physical Signs |
b. Personality Changes |
c. Other Behavioral Indicators |
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Flushed Face |
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Irritability |
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Decreased Quality of Work |
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Nervousness |
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Increased Defensiveness |
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Sporadic Work |
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Red or Bleary Eyes |
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Increased Use of Excuses |
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Mood Changes after Lunch |
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Hand Tremors |
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Intolerant of |
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Drinking Before Lunch |
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Subordinates |
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Hangovers on the Job |
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Drinking During the Day |
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Minor Illnesses |
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Drinking After Lunch |
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Minor Injuries |
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Drinking During Duty |
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Unexcused Absences |
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Longer Lunch Hours |
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Other |
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Absenteeism |
Improper Use of Drugs
d. Behavioral changes needed for soldier/employee to become
effective/functioning in until: |
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Unusual Excuses for Absences |
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Avoidance of Supervisor or |
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associates |
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13.PATIENT IDENTIFICATION (For typed or written entries give: Name - last, first, middle; grade; date; hospital or medical facility):
DA FORM 8003, FEB 2003 |
EDITION OF NOV 91 IS OBLOLETE. |
USAPA V1.00ES |
PAGE 1 OF 2
14. |
Other Problems: |
Financial |
Marriage/Family |
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Medical |
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Other |
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(specify) |
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Is soldier/employee seen by other helping agencies? |
Chaplain |
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Other |
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Community Mental Health Service |
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Commander's/Supervisor's Recommendation: |
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No further action needed at this time. |
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Soldier/employee needs alcohol and/or drug education. |
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I suspect soldier/employee has an alcohol and/or other drug problem. |
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Other (specify). |
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Immediate Supervisor's Name. |
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Date (YYYYMMDD) |
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Phone. |
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20. |
Commander's/Supervisor's Signature. |
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Date (YYYYMMDD) |
22. |
Phone. |
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REHABILITATION TEAM MEETING RESULTS (MANDATORY FOR MILITARY)
Record of contact with commanders/supervisors concerning this referral - Record
Note: Results of rehabilitation team meetings must also be recorded on SF 600.
*TO: |
FROM: |
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DATE: (YYYYMMDD) |
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1. Per your basic memorandum |
and agreements made |
during rehabilitation |
team meeting on |
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, the following actions have been taken by the Army Substance Abuse Program |
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(ASAP) in an effort to assist referred soldier/employee with his/her problem(s): |
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Returned to duty, no further action required. |
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Placed on extended evaluation (30/60 days). |
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Alcohol/drug education |
Date (YYYYMMDD) |
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Time: |
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Bldg#: |
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Rehabilitation: Track: |
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Date (YYYYMMDD) |
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Time: |
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Bldg#: |
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2. If you have any questions, please call the following counselor: |
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at: |
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Clinical Director |
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* Note for Federal Employees: To be completed ONLY with written consent of employee.
DA FORM 8003, FEB 2003
USAPA V1.00ES PAGE 2 OF 2