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For use of this form, see AR 40-66; the proponent agency is Office of The Surgeon General.

For use of this form, see AR 40-66; the proponent agency is Office of The Surgeon General. TO: (Include ZIP Code) FROM: (Medical Treatment Facility (Specify Clinic, Ward, etc.)) TYPED NAME AND SIGNATURE OF REQUESTING MEDICAL OR DENTAL OFFICER DATE

o Prescribes the following forms formerly prescribed by AR 40-15: DA Form 3365 (Authorization for Medical Warning Tag) (paras 15-3 and 15-5); and DA Label 162 (Emergency Medical Identification Symbol) (paras 13-1, 13-3, 13-4, and

Army Regulation AR 40-66 Medical Record Administration and Health Care Documentation establishes policies, procedures, and responsibilities for the maintenance and use of medical records within the Army Medical Department, ensuring the proper documentation of medical care and the safeguarding of patient information.

“Disability” under Social Security is based on your inability to work. For purposes of this claim, we want you to understand that “disability” means you are unable to work as defined by the Social Security Act.

With the initiation of DD Form 2766, information from the current DA Form 5571 and DA Form 8007-R will be transcribed onto DD Form 2766. Ink is required except in block 8 (d(9), below), the "ordering exam" section, which is explained in the use of block 7 (d(8), below), and the annotation of dosage, frequency, and purpose of significant or long ...

etc.), the HCP will complete a DA Form 3365, Authorization for Medical Warning Tag and submit the form to the Patient Administration Division (PAD). PAD will place a DA

What is DA FORM 3365? DA FORM 3365 is a standardized form used by the United States Army to authorize the issuance of a medical warning tag to service members. This tag serves as a critical alert mechanism, informing others of the wearer’s specific medical conditions that could require immediate attention in emergency situations.