DD Form 877. Medical/Dental Records or Information, Request For

DD Form 877 - Medical/Dental Records or Information, Request For is used to request medical and dental records or information from military medical facilities. This form is essential for obtaining medical and dental information for various purposes, such as medical treatment, disability claims, or personal records.

The form consists of sections where the requester provides details about the requested medical or dental records, including the patient's personal information, the purpose of the request, and the type of information needed. It also includes the requester's contact information for communication.

Important fields in this form include patient's personal information, details of the requested records or information, purpose of the request, and requester's contact information. Accurate completion is crucial to ensure that the correct medical or dental information is provided.

Application Example: Veterans seeking medical treatment or filing disability claims may use DD Form 877 to request their medical and dental records from military medical facilities. This form enables them to access necessary medical information for their healthcare needs.

Related Form: DD Form 877-1 is a related form used to request medical/dental records specifically from the National Personnel Records Center (NPRC) in St. Louis, Missouri.