DA Form 4700. Medical Record - Supplemental Medical Data

Form DA 4700 is used as a Medical Record - Supplemental Medical Data in medical facilities within the Army. This form serves as a supplemental record for storing additional medical data and information related to a patient's health and medical history.

The form consists of sections where specific medical data, such as diagnostic test results, medical procedures, and treatment plans, are recorded. It includes details of the patient's medical condition, relevant medical history, and any ongoing medical treatment or therapies. Additionally, the form may include sections for capturing healthcare providers' notes and observations.

Important fields in this form include accurate and comprehensive documentation of supplemental medical data. Accurate completion of this form is crucial to ensure that all relevant medical information is available and accessible for the patient's ongoing medical care and treatment.

Application Example: A patient is admitted to an Army medical facility with a complex medical condition. The attending healthcare providers complete Form DA 4700, recording additional medical data related to the patient's condition, including diagnostic test results, surgical procedures, and any ongoing treatments. The completed form is then added to the patient's primary medical record, providing a comprehensive and up-to-date view of the patient's health status. By doing so, the medical facility ensures the continuity of care and facilitates effective decision-making in the patient's treatment plan.

Individuals filling out this form should consider any additional supporting documents, such as laboratory reports or imaging results, that may be required to provide a comprehensive record of the patient's medical data.

Related Forms: There may not be direct alternatives to Form DA 4700, as it serves as a specialized supplemental medical data record. However, there might be other forms related to medical records or specific medical data documentation used in similar medical settings.