Dd Form 2795 PDF Details

Dd Form 2795 is a Department of Defense form used to authorize the release of medical and other records to authorized individuals. The form can be used to request records from military hospitals, doctors, clinics, or other medical providers. The authorization must include the name of the individual who will receive the records, as well as their relationship to the person who is receiving care. It's important to note that Dd Form 2795 must be completed by the patient or their legal guardian if the patient is a minor. Completed forms should be sent to: Department of Defense Health Agency DHA-Record Services (PDO) P.O. Box 16858 Falls Church, VA 22041-6858 ATTN: DD2795 Release of Medical Records Request

QuestionAnswer
Form NameDd Form 2795
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namespdha 2795, dd2795, dd 2795 fillable, dd form 2795 fillable

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