Download the form
Use DA Form 5225-R when you need to child development services (cds) medical dispensation record (lra). Full title: CHILD DEVELOPMENT SERVICES (CDS) MEDICAL DISPENSATION RECORD. Everything you need is on this page — the file, the entry rules, the routing. Edition July 1997, status not stated, 2 page(s), roughly 200 fields.
ACSIM is the proponent, AR 608-10 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.
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.
Free, unregistered, unmodified. What arrives is what the publisher released.
What the form asks for
- ACTROOM
- AUTHNAME
- BEGINDATE
- CDSPER
- CDSPERB
- CDSPERB_1
- CDSPERB_2
- CDSPERB_3
- CDSPER_1
- CDSPER_2
- CDSPER_3
- CHILDNAME
- ContentArea1
- DATESPONSR
- DATE_PD
- DOSAGEA
- DOSAGEB
- DUTYPHONE
- ENDDATE
- HOMEPHONE
- INSTR
- MEDFAC
- MEDICATION
- MONTH
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.
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.
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.
A stored file goes stale silently. The proponent revises, a new edition date is published, and your copy says nothing about it — so compare the printed date against the edition in force before typing into it again. Completed submissions on an earlier edition are not reopened.
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 ACSIM or the administrative office servicing your unit.
Questions and answers
- What is DA Form 5225-R?
- CHILD DEVELOPMENT SERVICES (CDS) MEDICAL DISPENSATION RECORD
- Which edition is current?
- July 1997
- Who is responsible for this form?
- ACSIM
- In which formats can it be downloaded?
- PDF, XFDL