Dd Form 877 1 PDF Details

The DD Form 877-1 is the official form that military treatment facilities use to request retired medical and dental records from the National Personnel Records Center (NPRC) in St. Louis, Missouri. NPRC accepts this form exclusively for record requests from authorized military entities.

Records available through this form include inpatient, outpatient, dental, psychiatric, and consultation records. Eligible requesters include military treatment facilities acting on behalf of active duty personnel, retired service members, their dependents, and certain federal employees.

To fill out the form correctly, gather the patient's full name at the time of treatment, Social Security Number, year of treatment, and the treating facility's name. Mark the record type requested and note any special instructions. Accuracy in these fields is essential for NPRC to locate the correct file.

Verify that records have been retired before submitting. Active records remain with the treating facility or service branch. Mail the completed form to NPRC in St. Louis. Processing time varies based on request volume.

Related forms: DD Form 2870 for authorizing third-party record release, and the medical records request form for non-military record requests.

QuestionAnswer
Form NameDd Form 877 1
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesform 877, dd 877, how do i fill out dd form877, dd 877 1

How to Edit Dd Form 877 1 Online for Free

Fill out DD Form 877-1 online using our free PDF editor. Click the "Get Form" button above to open the document. You can enter text in all fields, check boxes, add dates, and sign without printing or scanning.

Step 1: Enter the patient's identifying information. Include the full name as it appears in service records, Social Security Number, date of birth, and military branch. NPRC uses this information to locate the correct records file.

Part no. 1 in submitting dd 877 navy

Step 2: Specify the type of records needed. Select from inpatient, outpatient, dental, psychiatric, or consultation records. Enter the treatment year and the name of the facility where care was received. Include date ranges if known.

Ways to prepare dd 877 navy portion 2

Step 3: Complete the remarks and signature sections. Sign and date the form, add a return address, and note any special handling instructions. Review all fields before submitting by mail to NPRC.

Related forms: DD Form 2870 for third-party medical record authorization, DD Form 149 to apply for correction of a military record.

Frequently Asked Questions

Who can submit DD Form 877-1? Only authorized military treatment facilities may use this form to request records from NPRC. Veterans and family members must request records directly through the National Archives or VA.

How long does NPRC take to respond? Routine requests take several weeks. Requests tied to active medical treatment can be marked urgent for faster processing.

What if records were destroyed? Many Army and Air Force records were lost in the 1973 NPRC fire. In these cases, NPRC issues alternative documentation such as the NA Form 13042 to help reconstruct service information.