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Family Prefix for Sponsor
20
Family Prefix for Spouse
30
Family Prefix for Second Spouse
31
Family Prefix for Child
01
Family Prefix for Second Child
02
Family Prefix for Foreign Military
99
Health Record Section for Prev Med and Occupational Health
1
Health Record Section for Medical Care and Treatment
2
Health Record Section for Physical Quals, profiles and exposure
3
Health Record Section for Ancillary Services and Misc
4
Immunization Record
DD Form 2766C (Part 1)
HIV Testing
NAVMED 6000/2 (Part 1)
Baseline Audiogram
DD Form 2215 (Part 1)
Preventive and Chronic Care
DD Form 2766 (Part 1)
Record of Medical Care
SF 600 (Part 2)
Emergency Care and Treatment
SF 558 (Part 2)
Narrative Summary
SF 502 (Part 2)
Medical Record Continuation
SF 507 (Part 2)
Progress Notes
SF 509 (Part 2) and (Inpatient Health Record)
Consultation Sheet
SF 513 (Part 2)
Privacy Act Statement Health Care Record
DD Form 2005 (Part 2)
Line of Duty Determination
AF Form 348 (Part 2)
Record of Inpatient Treatment
AF Form 565 (Part 2)
Summary of Care
AF Form 1480 (Part 2)
Abstract of Service and Medical History
NAVMED 6150/4 (Part 3)
Third Party Collection Program
DD Form 2569 (Part 3)
Record of Disclosure
OPNAV 5211/9 (Part 3)
Request for Medical/Dental Records
DD Form 877 (Part 3)
Pre-Deployment Health Assessment
DD Form 2795 (Part 3)
Post-Deployment Health Assessment
DD Form 2796 (Part 3)
Post-Deployment Health Reassessment
DD Form 2900 (Part 3)
Report of Medical Examination
DD Form 2808 (Part 3)
Report of Medical History
DD Form 2807-1 (Part 3)
Physical Profile Serial Report
AF Form 422 (Part 3)
Lab Report Display
SF 545 (Part 4)
Radiologic Consultation Requests/Reports
SF 519 (Part 4)
Lab Results
SF 602 (Part 4)
Dental Health Questionnaire
NAVMED 6600/3
Dental Exam Form
EZ 603
Dental Treatment
EZ 603A
Patient Data Base
NAVMED 6550/14 (Inpatient Health Record)
Narrative Summary
SF 502 (Inpatient Health Record)
History Part 1
SF 504 (Inpatient Health Record)
History Part 2 and 3
SF 505 (Inpatient Health Record)
Physical Exam
SF 506 (Inpatient Health Record)
Doctors Orders
SF 508 (Inpatient Health Record)
Nursing Notes
SF 510 (Inpatient Health Record)
Vital Signs
SF 511 (Inpatient Health Record)
Patient Profile
NAVMED 6550/12 (Inpatient Health Record)
Medication Administration Record
NAVMED 6550/8
24hr I&O Worksheet
DD 792 (Inpatient Health Record)
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