DD Form 2780 is an official U.S. Department of Defense document that authorizes the release of medical or dental health information. Military personnel, veterans, and eligible TRICARE beneficiaries use it when they need to share protected health records with third parties such as lawyers, insurance companies, or family members.
This form is required in several situations:
Before you start, have your military ID and Social Security Number ready. The form collects personal identification details, a description of the specific records to be released, the recipient's contact information, the stated purpose of the disclosure, and an expiration date for the authorization.
After completing and signing the form, submit it directly to the military treatment facility (MTF) or TRICARE regional office that maintains the records. Retain a signed copy for your own records. Incomplete or unsigned forms are returned without processing, so review every field before you submit.
Depending on your situation, you may also need the DD Form 2870 Authorization for Disclosure, the DD Form 93 Record of Emergency Data, or the DD Form 2656 Retirement Data. For legal situations involving property or medical decisions, consider completing a Military Power of Attorney as well.
| Question | Answer |
|---|---|
| Form Name | DD Form 2780 |
| Form Purpose | Authorization for disclosure of medical or dental information |
| Issuing Agency | U.S. Department of Defense |
| Used By | Military service members and TRICARE beneficiaries |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | SSN, YYYYMMDD, 18-R, dd form 2780 |