Af Form 771 The official website for Air Force e Publishing Official websites use mil A mil website belongs to an official U S Department of Defense organization in the United States
DD Form 771 is used to prescribe eyewear for military personnel this form is subject to the privacy act of 1974 use dd form 2005 frame eyewear prescription date order number to lab from name last first grade address unit ad ng other a n af cg phs clinic patient ship to sphere cylinder axis decenter h prism h base r l dd form 771 jul 96 previous edition is obsolete title
Af Form 771
Af Form 771
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AF Form 1671 Detailed Hearing Conservation Data Follow Up Forms
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The official website for Air Force e Publishing Official websites use mil A mil website belongs to an official U S Department of Defense organization in the United States
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DD Form 771 is used to prescribe eyewear for military personnel
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THIS FORM IS SUBJECT TO THE PRIVACY ACT OF 1974 Use DD Form 2005 FRAME EYEWEAR PRESCRIPTION DD FORM 771 JUL 96 PREVIOUS EDITION IS OBSOLETE AD A AF MC Title DD Form 771 Eyewear Prescription July 1996 Created Date 20011207203633Z DAFI36 2903 Dress and Personal Appearance of Air Force Personnel AFI36 2406 Officer and Enlisted Evaluation Systems DAFMAN36 2806 Awards and Memorialization Program
AD NG A CGOTHER N AF PHS CLINIC PATIENT SHIP TO Use this space to specify blocks marked Other PRESCRIBING OFFICER AUTHORITY SIGNATURE DD FORM 771 JUL 96 EG Designed using Perform Pro WHS DIOR Aug 96 ACCOUNT NUMBER SSN PHONE ADDRESS CONTINUED THIS FORM IS SUBJECT TO THE PRIVACY ACT OF 1974 Use DD Form 2005 Title 1400 25 Volume 771 DoD Civilian Personnel Management System Administrative Grievance System The DoDI is printed word for word in regular font without editorial review DAF Form 679 Air Force Publication Compliance Item Waiver Request Approval DAF Form 847 Recommendation for Change of Publication DoDI 1400 25 V771 December 26 2013
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THIS FORM IS SUBJECT TO THE PRIVACY ACT OF 1974 Use DD Form 2005 ORDER NUMBER ACCOUNT NUMBER DATE YYYYMMDD AD RES NG RET OTHER A N AF MC CG PHS OTHER I DD FORM 771 JUL 96 PREVIOUS EDITION IS OBSOLETE SIGNATURE COPY 1 Returned with eyewear COPY 2 Entered in health record Please wait If this message is not eventually replaced by the proper contents of the document your PDF viewer may not be able to display this type of document
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Af Form 771 - THIS FORM IS SUBJECT TO THE PRIVACY ACT OF 1974 Use DD Form 2005 FRAME EYEWEAR PRESCRIPTION DD FORM 771 JUL 96 PREVIOUS EDITION IS OBSOLETE AD A AF MC Title DD Form 771 Eyewear Prescription July 1996 Created Date 20011207203633Z