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Download DA FORM 3822 – Report Of Mental Status Evaluation
| Form Number | DA FORM 3822 |
| Form Title | Report Of Mental Status Evaluation |
| Published | 06/01/2019 |
| Prescribing Pub | AR 40-66 |
| File Size | 42 KB |
What is a DA FORM 3822?
A DA FORM 3822 is a document that outlines a change in the status of a service member or veteran. It is used to communicate changes to the command team. Depending on the change, it may include a change to treatment or risk status. For example, a change in the status of a service member’s mental status may require additional documentation.
DA FORM 3822 – Report Of Mental Status Evaluation
The DA FORM 3822 – Report of Mental Status Evaluation (RMSE) provides the findings of an evaluation conducted by a medical professional for a pending discharge. The form is used by the Department of Defense in cases of mental health issues. The Army outlines the specific requirements for this form.
The form should include the following information: name of the service member, age, and gender; current and prior medical conditions; treatment options; and any prior hospitalization. The provider will then use the DA FORM 3822 to inform the command team of the changes in the patient’s profile. This document is also used to communicate changes in treatment plans and risk status.
DA FORM 3822 – Example
