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Army Publishing Directorate – DA Forms

    https://armypubs.army.mil/ProductMaps/PubForm/DAForm.aspx
    inspector general action request: tig: da form 1569: active: 02/1/2023: transcript of military record: g-1: da form 1574-1: active: 04/1/2016: report of proceedings by investigating officer: tjag: ... field medical record jacket: tsg: da form 4008-1-r: active: 02/1/1973: keypunch …

Forms & Templates | Health.mil

    https://health.mil/Reference-Center/Forms
    Get Copies of My Medical Records. Submit a Media Inquiry. Contact Us. Sitewide Search. Visit MHS on Instagram; Visit MHS on LinkedIn; Visit MHS on Facebook; Visit MHS on …

DD Form 877-1, 'REQUEST FOR …

    https://www.esd.whs.mil/Portals/54/Documents/DD/forms/dd/dd0877-1.pdf
    DD FORM 877-1 (BACK), APR 1998. INSTRUCTIONS FOR REQUESTING MEDICAL TREATMENT RECORDS FROM THE NATIONAL PERSONNEL RECORDS CENTER …

Executive Services Directorate

    https://www.esd.whs.mil/Portals/54/Documents/DD/forms/dd/dd2870.pdf
    Executive Services Directorate

REQUEST AND RELEASE OF MEDICAL …

    https://armypubs.army.mil/pub/eforms/DR_a/pdf/A4876.pdf
    REQUEST AND RELEASE OF MEDICAL INFORMATION TO COMMUNICATIONS MEDIA. For use of this form see AR 40-66; the proponent agency is the Office of The Surgeon …

Reynolds Army Health Clinic > Patient Resources > …

    https://reynolds.tricare.mil/Patient-Resources/Forms
    Defense Health Agency Forms. DHA Form 236: Pediatric (6 months-11 years) COVID-19 Vaccine Screening and Immunization. DHA Form 207: COVID-19 Vaccine Screening and …

Army Medical Center Darnall-Hood > Patient Resources

    https://darnall.tricare.mil/Patient-Resources/Patient-Administration-Department
    Information Line: 254-553-8641 or 254-553-9816. The ROI office copies official medical record sets within Carl R. Darnall Army Medical Center (CRDAMC) to include all …

About VA Form 10-5345 | Veterans Affairs

    https://www.va.gov/find-forms/about-form-10-5345/
    Get VA Form 10-5345, Request for and Authorization to Release Health Information. Use this VA form to authorize VA to share your health information with a …

Medical Records Release Authorization …

    https://eforms.com/release/medical-hipaa/
    Medicare HIPAA (Form CMS-10106). Download: Adobe PDF How to Get Medical Records. Accessing and obtaining your medical records is a …

Medical Records | Ohio State Medical Center

    https://wexnermedical.osu.edu/patient-and-visitor-guide/medical-records
    For additional information during normal business hours, please call Ohio State’s Medical Information Management: Main Campus at 614-293-8657. East Hospital at 614-257-2544. …



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