Links to important forms for the active duty dental program. Dd form 28, active dutyreserve forces dental examination the government. To obtain hard copies of current forms not available in electronic format, please contact your own military service or dod component forms management officer. Dd form 28 download fillable pdf or fill online department of. The dd 28 or the military dental form is completed by the dental treatment facility dtf or civilian provider and the gathered information is stored within personnel medical files. Dd form 25002999 executive services directorate washington. Dd form 28, active dutyreserve forces dental examination. Cancelled forms are not available in electronic formats. The dd form 28, dod active dutyreserve forces dental examination, will be used to assist the tdpenrolled national guardreserve forces in documenting. This statement serves to inform you of the purpose for collecting personal information required by the addp claim form and how it will be used. Dd28, department of defense active dutyreserveguardcivilian forces dental examination, 31 2017. Dd form 28 active duty reserve forces dental examination. Active dutyreserve forces dental examination the government requires all.
This form should be completed by the dtf or civilian provider and will be used to assist the services in documenting member dental health. Dd form 28 department of defense active dutyreserveguardcivilian forces dental examination is a form used for gathering dental information on. Active duty dental program appointment of appeal representative active duty service members in remote locations may appeal click to close the action you take if you dont agree with a decision made about your benefit. The dd form 28, dod active dutyreserve forces dental examination, will be used to assist the. Sign, fax and printable from pc, ipad, tablet or mobile. This form is meant to determine fitness for prolonged duty without ready access to dental care and is not intended to address the members comprehensive dental needs. A dd form 28 is a department of defense form is used for gathering dental information for military members who will spend an extended period of time away from dental services. Dd2558, authorization to start, stop, or change an allotment, 1212017, no, dfas. Dutyreserve guardcivilian forces dental examination form dd form 28. Active duty reserve forces dental examination the government requires all active duty and reserve members receive an annual dental examination.