Dd 2870 example-2025

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Archived Records Inpatient records are maintained for 5 years after the date of discharge. After such periods, the records are retired to the National Personnel Records Center (NPRC), St Louis, MO. Patients may obtain their retired records directly from NPRC online.
You may request paper copies of your medical records from the military hospital or clinic records office. If its been more than two years since your last appointment, youll need to request copies of your records from the archives.
PRINCIPAL PURPOSE(S): DD Form 2870 collects patient data and a patients, or their parents or legal representatives, authorization for a military treatment. facility or dental treatment facility or DoD health plan to use or disclose an individuals protected health information.
Begin by specifying your name, the entity authorized to disclose information, and the individuals or entities you authorize to receive it. Indicate the specific information and purpose for which it will be disclosed, add an expiration date or event, and sign and date the form to confirm your consent.
The fastest way to obtain a copy is through their website, at . Expect a two to three week wait to receive requested records. The SF-180 is also available at your local CalVet Veteran Services CVSO Locations​ or onli​​​ne.
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How to request medical records. To request medical records, please call 760.674. 3876 or fill out the form below. This field is for validation purposes and should be left unchanged.
Request for complete records: Providers needing complete Inpatient records may call (706) 787-0836/2939. Please allow three working days for pull list. Request for Inpatient records for patient care are completed within minutes.
The attached DD Form 2870, Authorization for Disclosure of Medical or Dental Information, authorizes Fox Army Health Center (FACH) to release medical information to specific individuals other than the patient for purposes other than treatment, payment or healthcare operations. Block 5: Mark all that apply.

dd 2870 form