DA Form 5192. Family Identification Sheet for a Child Receiving Service

DA Form 5192 serves as a family identification sheet for children receiving services within the Army's support systems. This form aids in maintaining accurate records of family details and facilitating communication and coordination for services.

The form consists of sections where the child's family provides their contact information, family structure, household members, and any relevant medical or support needs. Additional sections may include emergency contact information and consent for sharing information.

Important fields in this form include the child's name, family contact details, household members, and any medical or support needs. Accurate completion of this form is essential for ensuring that the appropriate services and support are provided to the child and their family.

Application Example: A military family enrolls their child in a youth program, and they complete DA Form 5192 to provide information about the child's family, including emergency contacts and any medical conditions. This form helps program coordinators communicate effectively with the family and ensure the child's safety and well-being.

No additional documents are typically required to complete this form, as it captures all relevant family identification and contact information.

No direct alternatives or analogues to DA Form 5192 are mentioned, as its purpose is specific to collecting family identification information for children receiving services.