DD Form 2005. Privacy Act Statement - Health Care Records

DD Form 2005, titled Privacy Act Statement - Health Care Records, is employed to inform individuals about the collection and use of their personal health information under the Privacy Act of 1974.

The form consists of sections that explain the purpose of collecting health information, the authority for collection, the routine uses of the information, and the individual's rights under the Privacy Act. This form ensures transparency and compliance with privacy regulations in the management of health records.

Filling out DD Form 2005 involves providing a clear and concise statement about the purpose of collecting health information and the intended uses of that information. The individual's rights and options related to their health data should also be clearly communicated.

Application Example: When a military service member or their family seeks medical care at a military treatment facility, they are presented with this form to understand how their health information will be collected, stored, and used. This ensures that individuals are well-informed about their rights and the protections provided by the Privacy Act.

No direct alternative forms are mentioned, but similar privacy notifications might be found in other contexts involving personal data collection, such as in civilian healthcare settings or in private sector organizations.