DA FORM 7692 – Active Duty For Medical Care Application

DAFORMS.NETDA FORM 7692 – Active Duty For Medical Care Application – DA FORM 7692 is a form that active duty medical care applicants need to submit. It authorizes a required isolation period in certain circumstances. For example, a Soldier may need to be isolated for a certain time due to COVID-19, but he can apply for a waiver or exemption to be allowed to travel.

Download DA FORM 7692 – Active Duty For Medical Care Application

Form Number DA FORM 7692
Form Title Active Duty For Medical Care Application
Published 03/01/2019
Prescribing Pub AR 600-77
File Size 121 KB

Where Can I Find a DA FORM 7692?

When you need to travel to a restricted area, you may need to get a DA FORM 7692. This document is used to request an exemption or waiver from a mandatory quarantine. Soldiers with COVID-19 may need to request this form during annual training. This form must be signed by the soldier and completed by the unit.

DA FORM 7692 – Active Duty For Medical Care Application

The DA FORM 7692 – Applications for Active Duty For Medical Care is a document used to request medical care for an active duty member. This form must be filled out and signed by the active duty member. It must also be completed by the unit or military medical authority. A medical provider must sign the form and include their full name, grade, and contact information.

DA FORM 7692 – Example

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