FAMILY CARE PLAN COUNSELING CHECKLIST DA FORM 5304, JUL 2020-2025

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  1. Click ‘Get Form’ to open the FAMILY CARE PLAN COUNSELING CHECKLIST DA FORM 5304 in the editor.
  2. Begin with Part I, where you will indicate your current family status. Carefully read each option and select the one that applies to you.
  3. In section B, acknowledge your understanding of the responsibilities regarding family care arrangements by checking the appropriate boxes.
  4. Proceed to sections C through R, ensuring you provide detailed information about guardianship arrangements and responsibilities. Use our platform's text fields to input necessary details clearly.
  5. Complete Part III and IV by having both you and your spouse (if applicable) sign and date the form electronically. Ensure all required signatures are obtained.
  6. Review all entries for accuracy before submitting. Utilize our platform’s review features to ensure everything is complete.

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To fill out the DA Form 5841, start by providing your personal details including your name and Social Security number. Next, designate your chosen guardians name and address clearly. Finally, ensure you and the designated guardian sign and date the form to validate it.
Here are some tips to help you build your family care plan: Outline arrangements for daily activities. Give details for family rules and behavior. Provide medical information. List close contacts and other resources. List an alternative caregiver. Note locations of important documents.
The plan should include important information about the person receiving care, including their: Name, date of birth, and contact information. Health condition(s). Medicines, dosages, and when/how they are given. Health care providers with contact information. Health insurance information. Emergency contacts.
1 DA Form 5304 Family Care Plan Counseling Checklist - Takes AR 600-20 and looks at it in pieces; going over why Soldiers need a Family Care Plan. Not all regulation aspects will apply to all Soldiers. Simply initial the boxes to show you understand AR 600-20. Sign with your Command.
Normally though, if the Soldier can not come up with a valid Family Care Plan within 30 days of being formally counseled that a plan is required, the unit will initiate and separate the Soldier.
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A Family Care Plan (FCP) is a method by which the Army ensures a Soldiers Family Member(s) are taken care of when the Soldier is absent due to military requirements. Pursuant to the FCP, the Soldier will appoint a guardian for the family member to act in the Soldiers place while he or she is unavailable.

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