Dd Form 877 DD FORM 877 SEP 67 REPLACES EDITION OF 1 JAN 60 USAPPC V1 00 WHICH MAY BE USED Title DD Form 877 Request for Medical Dental Records or Information September 1967 Author WHS ESD IMD Created Date
This is a PDF form for requesting medical or dental records or information from the Department of Defense It has sections for patient information records requested reply referral and return address This form is used to request medical or dental records from the National Personnel Records Center NPRC in St Louis Missouri It is authorized by AR 40 66 Navy 23 54 and AFR 168 4
Dd Form 877
Dd Form 877
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Dd Form 877 1 Fill Out Printable PDF Forms Online
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https://www.med.navy.mil/Portals/62/Documents/NMFSC/NMOTC/NAMI/ARWG/Forms/DD0877.pdf?ver=bFuH2NrBD0Rc7l6i2PJ1jQ%3d%3d
DD FORM 877 SEP 67 REPLACES EDITION OF 1 JAN 60 USAPPC V1 00 WHICH MAY BE USED Title DD Form 877 Request for Medical Dental Records or Information September 1967 Author WHS ESD IMD Created Date
https://william-beaumont.tricare.mil/Portals/149/DD877.pdf
This is a PDF form for requesting medical or dental records or information from the Department of Defense It has sections for patient information records requested reply referral and return address
DD Form 878 Military Mail Dispatched DD Forms
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DD Form 877 is the only request form for retired clinical and medical treatment records from Military Treatment Facilities MTFs Learn how to complete the form what records are available and where to send it to NPRC DD Form 877 1 is a form for military facilities to request retired medical treatment records from the National Personnel Records Center NPRC in St Louis Missouri The form has instructions items and remarks for completing the request and returning it to NPRC
Dd form 877 sep 67 eg replaces edition of 1 jan 60 usappc v1 00 which may be used Learn how to request a copy of your medical record transfer your record or release your information from the 633rd Medical Group You may need to fill out a DD Form 877 Authorization for Disclosure of Medical Information or a DD Form 2870 Authorization for Disclosure of Medical Information
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Figure 2 12 Request For Medical Dental Records Or Information DD Form 877
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DD Form 877 For active duty service members and their dependents we will attempt to retrieve their physical records on your behalf Once the records have been received to Outpatient Medical Records they will undergo a Quality Control inspection prior to being electronically signed into the PRT for tracking purposes After the records are Military medical facilities may request transfer of medical records using DD Form 877 during in processing at your next duty station Have a copy of your orders and all amendments available during this time Patients may request a copy of their records at any time and obtaining a complete copy is recommended if PCSing to a remote location for
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DD Form 877 1 Request For Medical Dental Records From The National
DD Form 877 1 Request For Medical Dental Records From The National
Dd Form 877 1 Fill Out Printable PDF Forms Online
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Dd Form 877 - Dd form 877 sep 67 eg replaces edition of 1 jan 60 usappc v1 00 which may be used