Download the form
Use DA Form 5190 when you need to clinician`s information. Full title: CLINICIAN`S INFORMATION. Everything you need is on this page — the file, the entry rules, the routing. Edition 02/01/2026, status ACTIVE, 2 page(s), roughly 128 fields. Note the supersession: a later edition exists, and this one applies only to records already completed on it.
Authority sits in two places. TSG owns the form, AR 608-75 says when it is raised and where it goes. Routine cases need neither read in full — the page itself carries the sequence. The entries are completed by their subject or by unit administrative staff working from what that person supplies.
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.
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. Xfdl means IBM Lotus Forms. The Lotus Forms Viewer opens it; pdf readers and word processors do not.
No charge, no account, no email address. The file is the published document, distributed unaltered.
What the form asks for
- ADDRESS
- BIRTHDATE
- CARE_NEED
- CARE_NEED_1
- CARE_NEED_10
- CARE_NEED_11
- CARE_NEED_2
- CARE_NEED_3
- CARE_NEED_4
- CARE_NEED_5
- CARE_NEED_6
- CARE_NEED_7
- CARE_NEED_8
- CARE_NEED_9
- ContentArea1
- DATE_A
- DATE_B
- NAME
- OTHER2
- PHYSICIAN
- Page1
- Page2
- R45
- R46
Header first, always. Name as your official records spell it, identification number, unit, date of preparation — these four index the finished record, and an error in them hides the document from anyone searching for it later. The substantive blocks can wait thirty seconds.
Move between fields with tab; the build-time order follows the page and misses nothing. Click check boxes and option buttons, and expect an exclusive group to release the old choice when you set a new one. The trap is field width. Single-line fields do not wrap, so an overlong entry displays complete on screen and prints cut at the margin — put it in remarks or on a continuation instead. Mark inapplicable fields rather than leaving them blank, since an empty box carries no information about whether the question was read.
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.
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.
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.
The files are copies of published Department of the Army forms. This site has no official connection, no authority to issue anything, and no basis for saying whether an office will accept a given submission. None of the text is legal advice. Real questions — entry, requirement, eligibility — belong with TSG or the administrative office servicing your unit.
Questions and answers
- What is DA Form 5190?
- CLINICIAN`S INFORMATION
- Which edition is current?
- 02/01/2026
- Who is responsible for this form?
- TSG
- In which formats can it be downloaded?
- PDF, XFDL, PDF