The DD Form 2766, also known as the Adult Prevention and Chronic Care Flowsheet, is a comprehensive military health document for recording a service member's health history. The Privacy Act of 1974 protects all data entered on this form.
The form has sections for allergies (drug and non-drug), chronic illnesses, current medications, hospitalizations, and surgeries. These records support medical care and deployment readiness. Personnel who need to share their records with outside providers can use the DD Form 2870 (Authorization for Disclosure of Medical Records).
Counseling topics on the form include nutrition, cancer prevention, safe sex, injury prevention, and mental health. The form also documents patient identification, sponsor details, and family medical history. This information helps providers plan long-term care for each service member.
Readiness data on the form includes DNA registration status, blood type, and immunization dates. Pre and post-deployment health assessments are also recorded here. Service members who need extra space for chronic care data can use the companion DD Form 2766C.
| Question | Answer |
|---|---|
| Form Name | DD 2766 Army Form |
| Form Length | 4 pages |
| Fillable? | Yes |
| Fillable fields | 555 |
| Avg. time to fill out | 37 min 20 sec |
| Other names | dd form 2766c vaccine administration record, dd 2766 army, dd 2766c, dd form 2766c |