Download the form
Use DA Form 3611-R when you need to food service division-patient satisfaction survey (lra). Full title: FOOD SERVICE DIVISION-PATIENT SATISFACTION SURVEY (LRA). Everything you need is on this page — the file, the entry rules, the routing. Edition 06/01/1970, status ACTIVE, 1 page(s), roughly 57 fields.
TSG is the proponent, TM 8-504 the prescribing authority. Read the directive only if something about your situation departs from the standard case. Otherwise the form is filled by the individual it describes, or by the records clerk keeping the file, and reviewed through the printed signature blocks.
The formats are PDF, XFDL, and the choice comes down to keyboard or pen. Fillable pdf for typing — live fields, tab order, saved entries. Printable pdf for handwriting — same page, no interactive objects, print it blank. Content is identical; only entry method differs.
Save the download and open it in a dedicated reader. That single step prevents the common failure: an in-browser viewer accepts your typing and discards it at tab close. Confirm with one field and one save cycle before committing the whole form. The xfdl copy needs the IBM Lotus Forms Viewer. That format runs in Army systems and nothing else reads it.
No charge, no account, no email address. The file is the published document, distributed unaltered.
What the form asks for
- COMMENTS
- ContentArea1
- FOOD_ITEMS
- NO_A
- NO_B
- NO_C
- NO_D
- NO_E
- Page1
- R54
- R55
- R56
- R57
- R58
- R59
- R60
- R61
- R62
- R63
- Rectangle1
- SUGGESTION
- T24
- T25
- T26
Start at the top and get the header exactly right. Official spelling of the name, identification number, unit, date. Everything downstream finds the record through those entries; nothing else on the page has that consequence.
Tab through the fields rather than clicking. The tab order was fixed when the form was built and generally follows the page, which catches boxes a mouse skips past. Check boxes and option buttons take a click, and an exclusive group clears the previous selection when you make a new one. Single-line fields do not wrap — text past the field width prints truncated while still showing in full on screen, which is why the loss is discovered after printing. Overflow goes to remarks or a continuation sheet. A field that does not apply gets the mark meaning none; blank space reads as an omission.
The signature closes the form and nothing precedes it. Draft status holds until it is applied, by hand or by an accepted electronic method. Countersignatures go in printed order, each dated at signing. Then one final read from the top, looking for the four recurring defects: empty mandatory fields, swapped digits in identification numbers, day-month inversion in dates, and residue from a reused file that goes forward as though intended.
Privacy Act statement first, personal entries second. The notice covers who is authorised to collect, why, who else routinely sees it, and whether you must answer. After completion the file carries personal data and is stored and sent under the corresponding safeguards.
Send it where the directive says: the office it names, the unit administrative channel, or the individual's file. Take your copy before submission. How long the record is held comes from the schedule for the series, not from the office holding it.
Related forms are found by series and number. DA series documents under the same proponent or the same prescribing directive are commonly required as a set, and any form named on the face of this one goes forward with it. Assemble continuations, covers and transmittals before submitting, not after the query comes back.
Edition date is the version number, printed on the page. Hold a locally saved copy against the current edition before reuse, since nothing on your machine signals a revision. Work already executed under a superseded edition remains as filed.
These are reproductions of published Department of the Army documents, offered for download. The site is independent, connected to nothing official, and issues no forms of its own. Nothing here is legal advice and no statement is made about acceptance by any office. Questions about an entry, a requirement or eligibility go to TSG or your servicing administrative office.
Questions and answers
- What is DA Form 3611-R?
- FOOD SERVICE DIVISION-PATIENT SATISFACTION SURVEY (LRA)
- Which edition is current?
- 06/01/1970
- Who is responsible for this form?
- TSG
- In which formats can it be downloaded?
- PDF, XFDL, PDF
Publisher notes
- 41-ITEM ALSO PRODUCED IN ELECTRONIC MEDIA