DD Form 2780 PDF Details

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.

Who Needs DD Form 2780

This form is required in several situations:

What Information the Form Requires

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.

How to Submit DD Form 2780

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.

Common Mistakes to Avoid

Related Military Forms

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.

QuestionAnswer
Form NameDD Form 2780
Form PurposeAuthorization for disclosure of medical or dental information
Issuing AgencyU.S. Department of Defense
Used ByMilitary service members and TRICARE beneficiaries
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesSSN, YYYYMMDD, 18-R, dd form 2780

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For other TRICARE-related documents, see the TRICARE EFT Form and the TRICARE Letter of Release.