Forces Dental Examination Form
The Forces Dental Examination Form is necessary for military personnel to assess dental health for deployment readiness. This form gathers essential patient information and examination results. It ensures the individual meets the dental health requirements for worldwide duty.
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How do I fill this out?
To fill out this form, begin by providing your personal details including name and DoD ID. Next, indicate your branch of service and unit assignment. Finally, a dentist will need to complete the examination section after assessing your dental health.
How to fill out the Forces Dental Examination Form?
1
Provide your personal information at the top of the form.
2
Fill in your branch of service and unit assignment.
3
Complete the examination results section.
4
Ensure your dentist provides their details and signature.
5
Submit the form as per the instructions provided.
Who needs the Forces Dental Examination Form?
1
Active military personnel need this form to assess their dental readiness for deployment.
2
Dental care providers require this form to record examination results for military members.
3
Reserve and National Guard members must complete this form for annual dental health evaluations.
4
Civilian employees working with military personnel should use this form to track dental health standards.
5
Healthcare administrators in the military need this form to maintain personnel health records.
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1
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2
Click on the field you wish to edit.
3
Enter the necessary information directly.
4
Review your changes to ensure accuracy.
5
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What are the instructions for submitting this form?
To submit the Forces Dental Examination Form, ensure all fields are accurately filled out. You can send the completed form to your unit's dental office via email at 123.mdg.sgd.dental@us.af.mil. Alternatively, fax it to the relevant department, or print and deliver it physically to your assigned health care provider. Always double-check for any specific submission instructions from your military unit.
What are the important dates for this form in 2024 and 2025?
The OMB approval for this form expires on January 31, 2023. Ensure to use the latest version for submissions in 2024 and 2025. Staying updated with the latest forms is crucial for compliance.
What is the purpose of this form?
The Forces Dental Examination Form is designed to gather necessary dental health information for military personnel. This information is essential in determining an individual's readiness for deployment and overall fitness for duty. By collecting these details, the form helps ensure that service members maintain optimal dental health, which is critical for operational effectiveness.
Tell me about this form and its components and fields line-by-line.
- 1. Service Member's Name: Collects the full name of the service member.
- 2. DoD ID Number: A unique identification number for Department of Defense personnel.
- 3. Branch of Service: Indicates the military branch the service member belongs to.
- 4. Unit of Assignment: Specifies the unit where the service member is assigned.
- 5. Examination Results: Includes the results obtained from the dental examination.
- 6. Dentist's Information: Captures the details of the dentist conducting the examination.
What happens if I fail to submit this form?
Failure to submit the Forces Dental Examination Form may delay the evaluation of a service member's dental health. This can hinder their ability to participate in deployments and could potentially leave them unprepared for military duties.
- Deployment Readiness: Delays can affect assessments that are critical for deployment.
- Health Monitoring: Lack of timely submissions hampers ongoing health monitoring for service members.
- Compliance Issues: Not submitting the form can lead to compliance concerns with military regulations.
How do I know when to use this form?
- 1. Annual Check-Up: To document annual dental assessments for military personnel.
- 2. Pre-Deployment Evaluation: To evaluate dental health prior to deployment.
- 3. Dental Emergency Assessment: Used in cases where dental issues arise unexpectedly.
Frequently Asked Question
What is the purpose of the Forces Dental Examination Form?
The form is used to assess dental health and readiness for military deployment.
Who needs to fill this form?
Active duty, reserve members, civilians, and their dental healthcare providers.
How can I edit this PDF?
You can easily modify the fields directly when you open the PDF in PrintFriendly.
What information is required on the form?
Essential personal details, dental examination results, and the dentist's information need to be provided.
Can I sign the PDF digitally?
Yes, you can add your digital signature directly on PrintFriendly.
How do I submit the completed form?
Follow submission instructions included on the form for sending it to the required authority.
Is there a deadline for submitting this form?
Refer to the specific instructions for submission timelines based on your military status.
Can I share this document with others?
Yes, you can easily share the PDF through email or social media platforms.
What if I make a mistake in the form?
You can edit the form as many times as needed before finalizing your submission.
Where can I find the OMB control number?
The OMB control number is printed at the top of the form under the title.
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