Download the form
Use DA Form 4028 when you need to prescribed medication. Full title: PRESCRIBED MEDICATION. Everything you need is on this page — the file, the entry rules, the routing. Edition 03/01/1973, status ACTIVE, unknown page(s), roughly unknown fields.
TSG is the proponent, AR 40-66 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 none published here, 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.
A standalone reader is the safe choice for fillable work. Browser viewers vary in whether entered data survives the session, and there is no warning when it does not; a one-field save test settles it in seconds.
Free, unregistered, unmodified. What arrives is what the publisher released.
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.
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.
Signature comes after every other entry — ink or an approved electronic means, and without it the document is a draft. Where reviewing, approving or witnessing signatures are called for, take them in printed block order, each dated on the day applied. Before release, one pass from the top. The defects worth hunting are always the same four: mandatory fields left empty, identification digits transposed, dates with day and month reversed, and stale data surviving in a copy reused in place of a blank form.
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.
What is distributed here are reproductions of published Department of the Army documents. Independent site, no official standing, no forms of its own. Nothing on the page constitutes legal advice, and acceptance by any office is outside what can be stated. Put questions about entries, requirements or eligibility to TSG or your servicing administrative office.
Questions and answers
- What is DA Form 4028?
- PRESCRIBED MEDICATION
- Which edition is current?
- 03/01/1973
- Who is responsible for this form?
- TSG
- In which formats can it be downloaded?
- No file published here