Download the form
Treat DD Form 2499 as Department-level, which changes how you look for it. Title: DD Form 2499, Health Care Practitioner Action Report, February 2000. Function: Health Care Provider Action Report. Because the number carries DD rather than a service prefix, the same edition covers all military departments and the defense agencies at once. Nobody issues a Navy copy or an Air Force copy.
Authority: not stated prescribes it, not stated maintains it. Those two names settle most disputes about why the form is being asked for. Local commands add timing on top; the requirement itself comes from above them.
Current edition is not stated, carried as not stated. Check that against any copy you already hold before doing anything else — Department-level revisions land everywhere simultaneously, so a stale file is stale across the whole Department.
The set is PDF. Size: 3 pages, about 147 fields. Everything below refines that choice.
Fillable pdf is the default choice. Its boxes hold typed entries inside the document; the printable release is a static image of the same page with no interactive layer. Since DD forms routinely cross between services and agencies before they are filed, typed entries matter more here than on a form that stays inside one office.
What the form asks for
- 2. Type of report. Press space bar to mark X in first box if initial, second box if correction or addition, third box if revision to action, or fourth box if void previous report.
- 1. Date of report (4 digit year, 2 digit month, 2 digit day).1. Date of report (4 digit year, 2 digit month, 2 digit day, no dividers).
- 1. Date of report (4 digit year, 2 digit month, 2 digit day).3. Date of action (4 digit year, 2 digit month, 2 digit day).
- 5. Medical treatment facility (MTF). a. Name.
- b. Address (street, city, state, zip code).
- c. DMIS code.
- 6. Practitioner information. a. Name (last, first, middle).
- b. Social security number. Do not include dashes.
- 4. Effective date of action (4 digit year, 2 digit month, 2 digit day).3. Date of action (4 digit year, 2 digit month, 2 digit day).
- d. Name of professional school attended.
- X first box if in U.S., second box if foreign.
- c. Date of birth (4 digit year, 2 digit month, 2 digit day).
- e. Date graduated (4 digit year, 2 digit month, 2 digit day).
- f. Status. X first box if Army, second box if Navy, third box if Air Force, fourth box if PHS, fifth box if civilian GS, sixth box if partnership internal, seventh box if partnership external, eighth box if personnel services contract, or ninth box if non-personnel services contract.
- g. Source of accession. (1) Military. X if volunteer.
- X if Armed Forces Health Professional scholarship program.
- X if Uniformed Services University of Health Sciences.
- X if National Guard.
- X if Reserve.
- X if other.
- Specify if other.
- (2) Civilian. X if Civil Service.
- X if contracted.
- X if consultant.
Edition check comes first, ahead of any entry. Compare the printed date to not stated and replace anything older. Department-level supersession is simultaneous across the services, so a superseded blank is not merely out of date locally; the office receiving it is already working from the new field structure whichever branch it belongs to.
Field-level questions go to the printed instructions, then to not stated, which is authoritative.
Send it as not stated or local guidance specifies. Save a copy. Cross-service and cross-agency routing is normal for Department forms, and a lost original outside your own organization is harder to chase down.
Related forms are found by number alone. The DD sequence is one unified Department-wide series, so a cited number resolves to exactly one document with no branch qualifier needed.
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.
Revision follows directive changes, changed data requirements and amended notice language, unannounced. Verify not stated each time rather than trusting a saved copy — the cost of the check is seconds.
Limits of this page: it distributes a published Department of Defense document and describes it. No legal advice, no procedural ruling, no statement about whether any submission will be accepted. Applicability, eligibility and procedure belong to not stated, to a servicing personnel office, or to the office named in not stated.
Questions and answers
- What is DD Form 2499?
- DD Form 2499, Health Care Practitioner Action Report, February 2000
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?