5 Army Dental Forms

Introduction to Army Dental Forms

The United States Army uses various dental forms to document and manage the oral health of its personnel. These forms are essential for maintaining accurate records, ensuring compliance with military regulations, and providing quality dental care. In this article, we will discuss five important Army dental forms, their purposes, and how they are used.

1. DD Form 2813 - Dental Patient Registration

The DD Form 2813 is used to register patients with the Army dental clinic. This form collects demographic and medical information, including the patient’s name, social security number, date of birth, and medical history. The form also includes a section for the patient to provide consent for treatment and release of medical information. Accurate completion of this form is crucial for ensuring that patients receive proper care and that their records are maintained correctly.

2. DA Form 5345 - Dental Examination

The DA Form 5345 is used to document the results of a dental examination. This form includes sections for recording the patient’s medical history, dental history, and the results of the examination, including any diagnoses or treatments recommended. The form also includes a section for the dentist to indicate whether the patient is deployable or non-deployable due to dental reasons. Deployability is a critical factor in the Army, and this form helps to ensure that personnel are fit for duty.

3. DA Form 7576 - Dental Treatment Plan

The DA Form 7576 is used to create a treatment plan for patients who require dental care. This form outlines the recommended treatment, including any procedures, medications, or follow-up appointments. The form also includes a section for the patient to provide consent for treatment and acknowledge their understanding of the treatment plan. Having a clear treatment plan in place helps to ensure that patients receive the care they need and that their treatment is coordinated effectively.

4. DA Form 7583 - Dental Record

The DA Form 7583 is used to maintain a patient’s dental record. This form includes sections for recording the patient’s dental history, treatment plans, and progress notes. The form also includes a section for recording any medications or allergies. Accurate and up-to-date dental records are essential for providing quality care and ensuring that patients receive the treatment they need.

5. DD Form 2936 - Dental Insurance Claim Form

The DD Form 2936 is used to submit claims for dental insurance benefits. This form includes sections for recording the patient’s demographic information, dental procedure codes, and treatment dates. The form also includes a section for the dentist to certify that the treatment was necessary and that the patient was eligible for benefits. Completing this form accurately and submitting it in a timely manner helps to ensure that patients receive the benefits they are entitled to.

💡 Note: These forms are subject to change, and it is essential to use the most current version to ensure compliance with Army regulations.

In summary, these five Army dental forms play a critical role in managing the oral health of Army personnel. By understanding the purpose and use of each form, dental professionals can provide high-quality care and ensure that patients receive the treatment they need.

The use of these forms also helps to ensure that patients’ records are maintained accurately and that they receive the benefits they are entitled to. Effective use of these forms is essential for maintaining the oral health of Army personnel and ensuring that they are fit for duty.