Download the form
DD Form 1924 is a Department of Defense form, not a service form: DD Form 1924, Surgical Checklist, October 1993., used to Surgical Checklist. The DD prefix is the operative fact. It means one blank serves every military department — Army, Navy, Air Force, Marine Corps, Space Force, Coast Guard under Defense jurisdiction — plus the defense agencies and combatant commands. No branch variant exists.
Requirement traces to not stated; the form belongs to not stated. Everything about schedule sits below that in local instruction, which is where to ask if a date matters.
Use not stated, status not stated. Older printings circulate widely and lose their currency Department-wide the moment a new edition issues.
Formats: PDF. Length 1 pages, approximately 58 entries. Pick on the basis of how you will complete it.
Take the fillable pdf unless you have a reason not to. Fillable means the boxes are real fields that accept typed text and retain it in the file. Printable means a flat blank — no fields, printer and pen only. The difference is not cosmetic: one produces a record that reproduces cleanly through scanning and forwarding, the other depends on penmanship.
What the form asks for
- Patient's identification.
- Unit/Room/Bed.
- Clinical records. Initial or mark N/A if not applicable. SF 515 - Tissue examination.
- SF 516 - Operation report.
- SF 517 - Anesthesia.
- SF 518 - Blood transfusion: number of units.
- SF 518 - Blood transfusion.
- SF 522 - Operative permit (signed and witnessed).
- SF 509 - Progress note (contains physician's informed consent).
- Blood transfusion consent.
- Medication administration record.
- IV flow sheet.
- History and physical.
- SF 511 - T.P.R. graphic.
- Nurses notes.
- Doctor's orders.
- X-ray (only the required) reports.
- Required X-ray films.
- Laboratory reports (only the required) hematology.
- Required laboratory urine test reports.
- EKG.
- Initial or N/A.
- Other (specify), line 1.
- Other (specify), line 2.
Start by matching the printed date to not stated. Old blanks accumulate in shared folders for years. Because the Department reissues to all services in one action, nobody is still accepting the previous layout by local custom.
Fill top to bottom. Identification, then substance, then certification — lower fields commonly derive from the header, and completing out of order produces internal contradictions a reviewer will catch.
Nothing stays blank. N/A on an inapplicable item, because an empty box is indistinguishable from a skipped question and the form returns for it. Dates follow the format printed beside the field, not local habit — a joint form is read by clerks in several services with different date conventions, and ambiguity is expensive.
The Privacy Act Statement precedes the personal data fields for a reason. It gives the collection authority, the principal purpose, the routine uses and whether disclosure is voluntary or mandatory. Read it while the disclosure decision is still yours to make.
Sign last, in ink or with a credentialed digital signature. A typed name in a signature field certifies nothing. CAC-based signing is the usual electronic method where the receiving system supports it. Date the block immediately — unsigned and undated certifications account for a large share of returns.
Check before submitting. The recurring failures are edition mismatch, gaps in required boxes, unreadable scanned handwriting, wrong date format, and certification without signature or date. Field-level questions go to the printed instructions, then to not stated, which is authoritative.
Route it where not stated or local procedure directs, and keep a copy first. On a Department form the receiving office is frequently outside your own chain — another service, a defense agency, a joint command — which makes recovering a lost original slower than it would be internally.
Look up cross-referenced forms by series and number. DD numbering is unified across the Department, which removes the usual step of identifying which service issued the thing.
Where a procedure cites both a service form and a DD form, the two are unconnected. Service numbering answers to a service proponent, DD numbering to not stated or another Department office, and the two sequences were never aligned. Matching numbers mean nothing whatever.
Editions change when the prescribing directive is reissued, when the data collected changes, or when notice language is amended. None of that reaches you. Checking not stated at download is the entire defence, and it is cheaper than repeating a submission.
What is here is the blank form and a description of it. What is not here is legal guidance or any assurance about a particular filing — this page is not the issuing authority and does not speak for one. Those questions go to not stated, to your servicing administrative office, or to the authority identified in not stated.
Questions and answers
- What is DD Form 1924?
- DD Form 1924, Surgical Checklist, October 1993.
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?