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DA Form 3705 — RECEIPT FOR OUTPATIENT TREATMENT/DENTAL RECORDS

receipt for outpatient treatment/dental records

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Use DA Form 3705 when you need to receipt for outpatient treatment/dental records. Full title: RECEIPT FOR OUTPATIENT TREATMENT/DENTAL RECORDS. Everything you need is on this page — the file, the entry rules, the routing. Edition 01/01/1980, status ACTIVE, 1 page(s), roughly 89 fields.

Two references decide everything about your use of it: TSG maintains the content, AR 40-66 sets the trigger and the routing. Consult the directive when your case is not routine; otherwise the printed blocks tell you enough. The person named in the entries fills it, or the administrative office holding the file does it for them.

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.

Use a full pdf reader, not the browser viewer. Browser viewers display fields they cannot always save, and the loss shows up only when you reopen the file — type one entry, save, reopen, verify, then fill the rest. The xfdl file is IBM Lotus Forms, used inside Army systems, and opens in the Lotus Forms Viewer alone — no pdf reader, no word processor.

Nothing is charged and no sign-up applies. Files are served as published, without changes to the page image.

What the form asks for

  • ContentArea1
  • DATE
  • DENTAL
  • DENTAL_1
  • DENTAL_2
  • DENTAL_3
  • DENTAL_4
  • DENTAL_5
  • DESTINAT
  • MEDICAL
  • MEDICAL_1
  • MEDICAL_2
  • MEDICAL_3
  • MEDICAL_4
  • MEDICAL_5
  • NAME
  • OUTPAT
  • OUTPAT_1
  • OUTPAT_2
  • OUTPAT_3
  • OUTPAT_4
  • OUTPAT_5
  • Page1
  • R63

The heading entries carry more weight than the body. Name spelled as in official records, identification number, organisation, date prepared. Retrieval runs on those values, so a transposed digit or a casual spelling costs someone a file search. Fill them before anything else.

Tabbing beats clicking for coverage. The order was set at build time and tracks the page layout, so following it leaves no gaps. Boxes and buttons are clicked; where options are exclusive, one selection cancels another by design. Watch field width on long entries: one-line fields have no wrap, and what runs past the edge disappears in print though the screen still shows it. Move that text to remarks or a continuation. Never leave an inapplicable field empty — enter the nil mark, because a reviewer cannot distinguish a skipped question from a considered answer.

Sign last. An unsigned form is a draft whatever else is on it, and additional signatures — reviewer, approver, witness — follow printed block order with each signer dating the day they sign, not the day of preparation. Four faults account for most returns: a blank mandatory field, transposed digits in an identification number, day and month reversed in a date, and leftover entries in a working copy reused instead of a fresh blank. Read the form once from the top before releasing it.

Read the Privacy Act statement at the point it appears. Authority, purpose, routine uses, mandatory or voluntary — four facts, and they govern what you are about to enter. A completed copy holds personal data and takes the handling rules that attach to it.

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.

Companion documents come from the same series and number scheme. Within the DA series, a shared proponent or a shared directive usually means shared use, and a form cited on the face of another accompanies it. Gather the whole package first — continuation sheets, cover sheets, transmittals.

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 3705?
RECEIPT FOR OUTPATIENT TREATMENT/DENTAL RECORDS
Which edition is current?
01/01/1980
Who is responsible for this form?
TSG
In which formats can it be downloaded?
PDF, XFDL, PDF

Publisher notes

  1. 14-REQUIRES PRIVACY ACT STATEMENT (AR 340-21)
  2. 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA

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