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- Click ‘Get Form’ to open the da 4465 in the editor.
- Begin with Section I - Identification. Fill in your date enrolled/screened, date of birth, and service area code. Ensure all information is accurate for proper identification.
- Next, check the appropriate boxes for department and eligibility category. This helps categorize your case effectively.
- In Section II, provide details about military personnel or civilian employee data, including sex, component, and grade. This section is crucial for understanding your status.
- Proceed to Section III where a physician will enter diagnosis codes and make enrollment decisions. Ensure that the physician's signature is included.
- Finally, complete Section IV by checking the basis for enrollment/screening and providing reasons if not enrolling. Don’t forget to have the counselor and clinical director sign off.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2001 | 4.8 Satisfied (44 Votes) |
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