Navigating the complexities of military life can be challenging for service members and their families, a fact well recognized by the Ombudsman Program. The Family Information Form for Ombudsman Service stands as a cornerstone document designed to facilitate seamless communication and support between military families and Ombudsman volunteers. This form collects essential details about the service member, such as their rank, contact information, projected rotation date, and family specifics, including spouse and children’s information. Notably, it inquires if the family is new to the San Diego area, which can be crucial for those seeking local resources and community integration. The form goes beyond basic contact details, requesting emergency contact information and permission to share command information and newsletters with extended family members, ensuring that a broad network of support is available to each family. The aim is clear: to ensure that Ombudsmen, who act as invaluable information and referral sources but not counselors, have all the necessary information to guide military families toward the right services and programs, such as the Exceptional Family Member Program (EFMP) and school liaison officers. This form reflects a privacy-conscious approach, emphasizing voluntary disclosure but also noting that failure to provide information may limit the Ombudsman’s ability to assist effectively. In this manner, the Family Information Form serves as a pivotal tool in the Ombudsman's mission to support military families through challenges, leveraging resources, and fostering a strong military community.
| Question | Answer |
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| Form Name | Form Ombudsman |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | family form ombudsman, information form ombudsman online, form ombudsman pdf, form ombudsman |
Family Information Form For Ombudsman
Service Member's Name |
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Rank/Rate |
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Dept/Division |
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Work phone # |
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Work Email |
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Projected |
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Address |
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Rotation Date |
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Mailing Address: |
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Street, City, State and Zip |
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Closest Military Facility to |
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Home |
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New to San Diego Area? |
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Spouse's Name (if applicable) |
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Mailing Address: |
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(if different from |
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above) |
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Spouse's Contact Info |
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Home Phone |
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Cell Phone |
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Work Phone |
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Name |
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Age |
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Children's Info |
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Primary Emergency |
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Point of Contact |
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Secondary Emergency |
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Point of Contact |
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Anyone Else you would |
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like command information |
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and newsletters to be |
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sent to (e.g. parents) |
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Mailing Address |
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I authorize the Ombudsman to use this information for official purposes only. I understand ALL information is confidential
Signature: |
Date: |
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THE OMBUDSMAN IS A SOURCE OF INFORMATION AND REFERRAL ON ANYTHING AFFECTING COMMAND FAMILY MEMBERS. THEY ARE NOT COUNSELORS, BUT MAY DIRECT THE FAMILY MEMBER TO THOSE THAT WILL PROVIDE THE SERVICE OR INFORMATION DESIRED. THIS MAY INCLUDE ISSUES SUCH AS EXCEPTIONAL FAMILY MEMBER PROGRAM (EFMP); SCHOOL LIAISON OFFICERS; AND MANY OTHER RESOURCES.
PURPOSE: INFORMATION IS USED TO PREPARE ORGANIZATIONAL LOCATOR, RECALL ROSTER, AND SIMILA ADMINISTRATIVE USES REQUIRING PERSONNEL DATA.
ROUTINE USES: CONTACTING APPROPRIATE PERSONNEL WHEN NEEDED WHILE FULFILLING THE DUTIES AND RESPONSIBILITIES OF AN OMBUDSMAN INCLUDING REFERRAL ON MATTERS AFFECTING COMMAND FAMILY MEMBERS.
DISCLOSURE: VOLUNTARY. HOWEVER, FAILURE TO PROVIDE THE REQUESTED INFORMATION MAY RESULT IN THE OMBUDSMAN'S FAILURE TO PROVIDE HIS/HER SERVICES TO THE SERVICE MEMBER AND THEIR FAMILY MEMBERS.
PRIVACY ACT STATEMENT: TITLE 5, U.S. CODE 552A - REFERENCE TO THE PRIVACY ACT, SECNAV 5211.5E - THE DON PRIVACY PROGRAM, NAVADMIN
If this information changes, please contact your Ombudsman at (619) 545 1701. Thank you!