DA Form 5028-R. Medcase Support and Transmittal Form (LRA)

Form DA 5028-R is a Medcase Support and Transmittal Form (LRA). This form is used in the Army to transmit medical case management information between healthcare providers and case managers. The purpose of this form is to facilitate the exchange of essential medical information to ensure continuity of care for beneficiaries.

The form consists of sections where the healthcare provider or case manager provides information about the beneficiary's medical condition, treatment plan, and any changes in the medical management. The form may also include sections for documenting the date of transmission and any additional remarks or instructions.

Important fields in this form include accurate and comprehensive medical information, including the beneficiary's current condition, treatment plan, and any updates in their medical management. Ensuring the timely and accurate transmission of medical information is crucial for providing continuous and effective healthcare services.

Application Example: A healthcare provider needs to transfer a patient's medical case to a different facility with specialized case management services. The provider uses Form DA 5028-R to transmit the patient's medical information, including diagnosis, treatment plan, and medical history, to the new case manager.

Related Forms: There may be other forms used for transmitting medical information and records between healthcare providers and case managers.