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ADULT PREVENTION AND CHRONIC CARE FLYSHEET (This form is subject to the Privacy Act of 1974 Use DD form 2005) 1. ALLERGIES a. MEDICATION ALLERGIES b. OTHER ALLERGIES 2. CHRONIC ILLNESS 3. MEDICATIONS
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How to fill out dd 2766 army form
How to fill out dd2766:
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Obtain a dd2766 form from your respective department or branch of the military.
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Fill in the required personal information, including your name, rank, social security number, and unit.
03
Provide details about your medical condition by accurately documenting the symptoms, diagnosis, and treatment received, if applicable.
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Include any relevant medical history and previous incidents or injuries that are related to your current condition.
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Provide information about any medications or medical devices that you are currently using or have used in the past.
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Ensure that all information provided is accurate and up to date.
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Sign and date the dd2766 form.
Who needs dd2766:
01
Military personnel who have a medical condition that may affect their ability to perform their duties.
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Individuals who require medical evaluation or treatment for military-related injuries or illnesses.
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Military medical personnel responsible for assessing and documenting the health status of personnel.
Note: It is important to consult with your commanding officer or the appropriate medical personnel to determine if the dd2766 form is necessary in your specific situation. The specific requirements for the form may vary depending on the branch of the military and individual circumstances.
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