Form 4254-2025

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4.8 out of 5

162 votes

The document is a U.S. Department of Defense form (dod-da-4254) used to request private medical information. It includes sections for patient details, the medical treatment facility, reasons for the request, and specifics about the medical information sought. Additionally, it contains fields for approval status and a summary of the released information.

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Versions	Form popularity	Fillable & printable
2003	4.8 Satisfied (162 Votes)

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