Department Of Defense Reserve Forces Dental Examination Form

The Soldier completes Sections 1-5.

Department of defense reserve forces dental examination form. An assessment by a dentist of the state of your dental health for the next 12 months is needed to determine your fitness for prolonged duty without ready access to dental care. Department of Defense Force Health Protection policy requires the Services to conduct annual health assessments of. Printable and fillable Department of Defense Active DutyReserve Forces Dental Examination. DD Form 2813 is fillable.

There are four readiness classes in total. Department of Defense Active DutyReserve Forces Dental Examination. Public Law 105-85 Sec. Examination results on this form to determine your patients fitness for prolonged duty without ready access to eye care.

An assessment by a dentist of the state of your dental health for the next 12 months is needed to determine your fitness for prolonged duty without ready access to dental care. Additionally United Concordias network dentists will complete the Department of Defenses Active DutyReserve Forces Dental Examination DD Form 2813 at no additional cost for TDP-enrolled National Guard and Reserve sponsors. A claim denial by contacting United Concordia in writing. Army Dental Examination Form.

Please mark X the block that best describes the. Active dutyreserve forces dental examination dd form 2813 A DD Form 2813 is a Department of Defense form is used for gathering dental information for military members who will spend an extended period of time away from dental services. Download Form 2813 Dental Examination. Public Law 105-85 Sec.

Dental Reserve or National Guard personnel who receive dental care from non-Armynon-military dental providers can still update their Dental Readiness. 0720-0022 OMB approval expires Jul 31 2009 The public reporting burden for this collection of information is estimated to average 3 minutes per response including the time for reviewing instructions searching existing data sources gathering and maintaining the. If you would like to authorize another individual to file a claim on your behalf eg spouse or other family member complete the Authorization to Appeal. This allows the National Guard or Reserve sponsors to provide the form to their designated military service representative to ensure dental readiness requirements.

The non-Army dentist completes Section 6-11. The DOD will not use the information on this form to address or document your patients comprehensive ocular health or visual needs. BRANCH OF SERVICE The individual you are examining is an Active DutyGuardReserveCiviIian member of the United States Armed Forces. This member needs your assessment of hisher dental health for worldwide duty.

This form is used to determine dental. Class I is given to soldiers with perfect oral hygiene who are not expected to require dental treatment or re-evaluation for the next 12 months. DD Form 2813 Active DutyReserve Forces Dental Examination October 2013 Author. DD FORM 2813 SEP 2006 DEPARTMENT OF DEFENSE ACTIVE DUTYRESERVE FORCES DENTAL EXAMINATION PREVIOUS EDITION MAY BE USED.

DEPARTMENT OF DEFENSE RESERVE FORCES DENTAL EXAMINATION PRIVACY ACT STATEMENT AUTHORITY. 0720-0022 OMB approval expires Jul 31 2009 The public reporting burden for this collection of information is estimated to average 3 minutes per response including the time for reviewing instructions searching existing data sources gathering and maintaining the. Department of Defense Active DutyReserve Forces Dental Examination free download and preview download free printable template samples in PDF Word and Excel formats. Active duty service members in remote locations may Appeal The action you take if you dont agree with a decision made about your benefit.

Print out the form and take it to your non-Army Dental provider. Fillable and printable Army Dental Examination Form 2021. Download free printable Department of Defense Active DutyReserve Forces Dental Examination in PDF Word Excel. Appointment of Appeal Representative.

DEPARTMENT OF DEFENSE ACTIVE DUTYRESERVE FORCES DENTAL EXAMINATION PRIVACY ACT STATEMENT AUTHORITY. Additionally completion of the form is considered to be part of the examination service and therefore is not a separately billable item. DD FORM 2813 SEP 2006 DEPARTMENT OF DEFENSE ACTIVE DUTYRESERVE FORCES DENTAL EXAMINATION PREVIOUS EDITION MAY BE USED. DD Form 2808 Report of Medical Examination is a form used by the Military Entrance Processing Station MEPS Medical Staff to obtain the health-related data required to determine the medical fitness of applicants and current members of the Armed Forces.

This award titled Reserve Health Readiness Program provides health readiness support services to the military service components to meet medical and dental standards essential in. Department of Defense Active DutyReserve Forces Dental Examination. Class II is given to soldiers who have oral conditions that if not treated or followed up have the potential. SOCIAL SECURITY NUMBER 5.

EXAMINATION RESULTS Dear Doctor 2. This form - sometimes referred to as DA Form 2808 DD Form 2808 1 and DD Form 2808 2 - was previously reviewed by the Department of.