Pdf filller 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's home address or duty station in the designated fields, including street address, city, state, and zip code.
3. Fill in the arrival time and provide the duty/local phone number along with the home phone number.
4. Indicate military status and whether there is third-party insurance by selecting 'Yes' or 'No'.
5. Complete the medical history section by noting any current medications and allergies.
6. Document vital signs such as pulse, temperature, and blood pressure in their respective fields.
7. Finally, ensure that all required signatures are provided at the end of the form for validation.

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