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The scope here is Department-wide. DD Form 2770 — DD Form 2770, Abbreviated Medical Record, April 1998. — exists to Abbreviated Medical Record, and it applies across the services rather than inside one. That is what the DD prefix encodes: joint issue, single edition, every branch and defense agency working from identical paper.
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 16 entries. Pick on the basis of how you will complete it.
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
- Press this Reset button to clear the data from all fields.
- 11. Press space bar to mark X if copy placed in outpatient record.
- 1. Admission date (4 digit year. 2 digit month. 2 digit day).
- 2. Chief complaint, pertinent history and pertinent system review.
- 3. Results of physical examination (Including pertintent positives and negatives).
- 4. Impression (Enter admission note with plan on progress notes).
- 5. Admitting Officer. a. Signature.
- 5.b. Date signed (4 digit year, 2 digit month, 2 digit day).
- 7. Discharge date (4 digit year, 2 digit month, 2 digit day).
- 6. Discharge note (Brief hospital course, diagnoses, procedures, condition on discharge, pertinent discharge information (including medications, diet, activity limitations, follow-up instructions)).
- 8. Discharging officer. a. Name (last, first, middle initial).
- 8.b. Grade.
- 8.c. Title.
- 8.d. Signature.
- 9. Patient identification (For typed or written entries: Name (last, first, middle), Grade, SSN, Date of Birth, Hospital or medical facility, Ward number and register number).
- 10. Outpatient and or health record maintained at:
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.
Work the printed sequence: header, body, signature block. The order is functional rather than decorative, since entries below frequently key to identifying data above them.
Mark inapplicable items N/A rather than leaving white space. Use the date format the form specifies. This matters more on Department forms than on service forms: the record may be reviewed by personnel outside your branch who share none of your office conventions.
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.
Final pass, against the standing defect list: superseded edition, empty mandatory fields, handwriting illegible after scanning, non-conforming dates, missing signature or date. For anything ambiguous in a specific field, the form's own instructions come first and not stated controls where the two differ.
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.
A number is a complete address in the DD series. Because the sequence is Department-level and not duplicated per service, there is nothing further to specify.
Do not read across from a service number. DA numbering is Army-specific under an Army proponent; DD numbering is Department-wide under not stated or an equivalent Department office. The sequences are unrelated, so identical digits in each identify two different documents. Read the prefix, not the digits.
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.
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 2770?
- DD Form 2770, Abbreviated Medical Record, April 1998.
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?