Blank Dd 689 PDF Template

1. What is a DD 689 form used for?

   A DD 689 form, commonly known as the Individual Sick Slip, is used in the military to document a service member's illness or injury. It serves as an official request for medical evaluation or treatment, and records the disposition of such cases, including whether the service member is to return to duty, be placed in quarters, sent to sick bay, hospitalized, or given another specified treatment.

2. Who needs to fill out a DD 689 form?

   The DD 689 form is completed by both the service member seeking medical attention and the medical officer providing the consultation or treatment. The initial part of the form, including details of the illness or injury and personal identification, is filled out by the patient. The medical officer and unit commander complete the remainder, documenting the medical assessment and decision regarding the patient's duty status.

3. What information is required on the DD 689 form?

   Information necessary for the DD 689 includes the date, details of the illness or injury, the patient’s last name, first name, and middle initial, their organization and station, service number or SSN, and grade/rate. The form also has sections for the unit commander and medical officer to complete, including whether the condition was in the line of duty, remarks, disposition of the patient (e.g., return to duty, quarters, sick bay, hospital), and both parties' signatures.

4. How is the 'In Line of Duty' section on the form determined?

   The 'In Line of Duty' section on the DD 689 form is crucial as it determines whether the illness or injury occurred under circumstances that are considered as part of the service member's official duties. This determination, made by the medical officer and sometimes in consultation with the unit commander, impacts the level of care and benefits the service member is entitled to. If an injury or illness is deemed not to have occurred in the line of duty, there could be implications for the service member's eligibility for certain medical treatments and benefits.

5. What does the 'Disposition of Patient' section entail?

   The 'Disposition of Patient' section captures the medical officer’s determination about the appropriate next steps for the patient. Options include returning the individual to duty if they are fit, recommending rest in their quarters, sending the patient to the sick bay for closer observation, hospitalization if required, or marking them 'Not Examined' with a specification for another course of action. This section is essential for understanding the immediate future of a patient’s service status following the medical evaluation.

6. How is the DD 689 form processed?

   After the DD 689 form is filled out, it is processed through the service member’s chain of command and the medical department. The unit commander and medical officer must provide their signatures to validate the information and decisions made regarding the service member’s condition and duty status. The completed form becomes part of the service member's health record, ensuring continuity of care and proper documentation for future reference.

7. Where can service members obtain a DD 689 form?

   Service members can obtain a DD 689 form from their unit’s medical department or the base medical facility. It is also accessible online through the Department of Defense's official forms website or through the service member's medical command's resources. It is advisable to consult with a unit's medical staff if there is any question about how to properly complete or submit the form.

Filling out the DD Form 689, or Individual Sick Slip, requires attention to detail. Avoiding mistakes ensures the form serves its purpose without causing delays or misunderstandings. Here are seven common mistakes people make:

1. Not double-checking the Date of Illness or Injury section for accuracy. This information is critical for timely processing and care.

2. Filling in the Last Name, First Name, and Middle Initial fields incorrectly or using nicknames instead of the full legal name, which can lead to identification issues.

3. Omitting or inaccurately reporting the Service Number/SSN, which is a crucial identifier for the individual's military records.

4. Forgetting to specify the exact nature of the condition in the Illness/Injury section, which can lead to ambiguity about the patient's needs.

5. Leaving the Disposition of Patient section incomplete, which is important for documenting the required or recommended care path.

6. Not obtaining the necessary Signatures from both the Unit Commander and Medical Officer, which are essential for validating the sick slip.

7. Overlooking the need to indicate whether the illness or injury occurred In Line of Duty, which can impact considerations for service-related benefits.

Avoiding these common errors during the completion of the DD Form 689 will aid in ensuring the document is processed smoothly and efficiently, facilitating the well-being of the individual concerned.

When managing the health and well-being of military personnel, the DD Form 689, commonly known as the Individual Sick Slip, plays a primary role in documenting their medical condition and treatment. This form is often accompanied by several other important documents and forms that ensure comprehensive care and documentation. Below is a list of additional forms and documents frequently used alongside the DD Form 689.

• DD Form 214: Certificate of Release or Discharge from Active Duty. This form is essential for veterans as it provides a comprehensive record of their military service, including health-related information at the time of discharge.
• DA Form 3349: Physical Profile. This document details an individual’s physical capabilities and any limitations, providing a clear understanding of their fitness for duty.
• DD Form 2807-1: Report of Medical History. Before deployment or entry into service, this form is filled out, offering a thorough medical history that complements current condition reports like the DD 689.
• DD Form 1172-2: Application for Identification Card/DEERS Enrollment. While not directly medical, this form is essential for access to military and medical facilities and services.
• DA Form 31: Request and Authority for Leave. This form may be used in conjunction with the DD 689 when a service member requires time off for medical reasons.
• DD Form 2574: Blood Donor Record. This form documents any blood donations, important for understanding a patient's recent medical interventions or conditions.
• DD Form 1380: Tactical Combat Casualty Care (TCCC) Card. Used in combat or field conditions, this form records immediate care given to casualties, complementing the sick slip for a complete medical record.
• DA Form 7652: Command-directed Mental Health Evaluation. This form may accompany the DD 689 if there are concerns regarding a service member’s mental health that require further evaluation.

Together, these documents provide a comprehensive system for tracking the health and medical treatments of service members, from entry into service to post-discharge care. Each plays a specific role in ensuring that individuals receive the appropriate care and support they need while also maintaining a detailed record for future reference.

• The DA Form 31, also known as Request and Authority for Leave, is comparable to the DD 689 form. Both forms are used within the United States Department of Defense. The DA Form 31 facilitates the processing of leave requests for Army personnel, specifying the duration and type of leave, similar to how the DD 689 document records the medical condition and treatment actions for military personnel, marking their availability for duty or need for medical leave.

• The NAVMC 118(11) is a document used by the United States Marine Corps to track service members' medical and dental examinations. Like the DD 689 form, it is part of a service member's medical record, documenting health status and fitness for duty. Both forms are integral in managing and assessing the readiness of military personnel, ensuring they are medically fit to fulfill their designated roles.

• The Air Force Form 422, or Physical Profile Serial Report, resembles the DD 689 in its purpose of documenting an individual's medical status. This form focuses on profiling the physical limitations of Air Force personnel, which can determine their deployment status, similar to how the DD 689 identifies limitations due to illness or injury, impacting their duty status.

• The Standard Form 600 (SF 600), also known as the Chronological Record of Medical Care, shares similarities with the DD 689 form. Both documents are used to record medical treatments and evaluations. The SF 600 is a detailed log of all medical encounters and treatments received over time, serving a complementary role to the DD 689, which specifically documents the assessment and disposition of a patient for a particular incident of illness or injury.

When filling out the DD 689 form, accurately documenting an individual's medical condition and related details is essential. This form serves as a record for sick slips in the military, vital for ensuring personnel receive the appropriate medical attention and support. The following are recommendations on what you should and shouldn't do during the process:

• Ensure all information is accurate and up-to-date, including the date of illness or injury, and the individual's personal details such as their last name, first name, middle initial, organization and station, service number/SSN, and grade/rate.
• Clearly specify whether the situation occurred 'In Line of Duty' to accurately reflect the circumstances surrounding the illness or injury.
• Use legible handwriting or type the information to prevent misunderstandings or errors in interpretation.
• Include detailed remarks when necessary to provide additional context or information about the patient's condition, which can be crucial for the medical officer and unit commander.
• Ensure that both the unit commander and the medical officer sign the form to validate the information and actions taken.
• Review the entire form before submission to confirm that all sections are completed and no crucial information is missing.

• Leave any sections blank if they are applicable. If a particular section does not apply, it's better to mark it as 'N/A' (not applicable) rather than leaving it empty.
• Forget to specify the disposition of the patient (duty, quarters, sick bay, hospital, not examined, or other) as this information directs the next steps for care and support.
• Use abbreviations or terminology that may not be universally understood without providing proper explanations, to avoid misinterpretations.
• Ignore the importance of the 'Remarks' sections under both the unit commander and medical officer. These sections offer a valuable space to elaborate on the patient's condition, prognosis, and any recommended accommodations or restrictions.
• Alter any details after the form has been signed by the medical officer or unit commander. If corrections are necessary, the proper procedure involves discussing them with and obtaining approval from the relevant authorities.
• Rush through filling out the form, as missing or inaccurate information could impact the individual’s medical care and record accuracy.

Understanding the DD Form 689, or the Individual Sick Slip, is essential for service members and their commanding officers. However, several misconceptions surrounding this form can lead to misunderstandings about its use and implications. Here are ten common misconceptions clarified for a better understanding of the DD Form 689:

• Misconception 1: The DD Form 689 is only for reporting severe injuries or illnesses.

  In truth, this form should be used to report any illness or injury, regardless of severity, to ensure proper documentation and care.

• Misconception 2: You need to fill out the DD Form 689 personally to receive medical attention.

  While it's true that the individual should complete the form when able, a commanding officer or another individual can fill it out on behalf of someone who is incapacitated or unable to do so.

• Misconception 3: The DD Form 689 is only relevant at military hospitals.

  This form is necessary for medical documentation within all military medical facilities, but it's also used for reporting purposes within the individual's unit or command, not just at hospitals.

• Misconception 4: Submitting a DD Form 689 will automatically excuse you from duty.

  The disposition of the patient, including whether they are excused from duty, is determined by a medical officer, not the mere submission of the form.

• Misconception 5: The DD Form 689 affects a service member's medical record permanently.

  While the form is part of the individual's medical history, it's more a snapshot of a specific incident rather than a permanent reflection of their health status.

• Misconception 6: Only the medical officer's section is necessary for the form to be processed.

  Both the unit commander's section and the medical officer's section are vital for the form's processing and the subsequent care or duty adjustments for the individual.

• Misconception 7: The "Line of Duty" designation is an automatic indication of wrongdoing or negligence.

  Being "In Line of Duty" simply means the injury or illness occurred while the service member was performing official duties, without implying any misconduct.

• Misconception 8: A DD Form 689 is required for every visit to a medical officer.

  This form is typically used for initial documentation of an illness or injury. Follow-up visits may not require a new form unless there is a significant change in the individual's condition or disposition.

• Misconception 9: The DD Form 689 is the only form needed for medical treatment.

  While important for initial documentation and internal military processes, other forms and medical records may be required for comprehensive treatment and documentation.

• Misconception 10: Digital submissions of the DD Form 689 are not permitted.

  With advancements in technology and efforts to streamline military processes, digital submissions of the DD Form 689 are increasingly accepted, provided they follow the proper protocols and systems in place.

Clarifying these misconceptions ensures that service members and their commanders can properly use the DD Form 689 for its intended purpose—promoting prompt, effective medical care and accurate documentation for those serving in the military.

The DD Form 689, commonly recognized as the Individual Sick Slip, serves as a crucial document within the military for documenting health-related absences. By accurately completing this form, individuals ensure their conditions are officially recorded, which can impact their service and benefits. Below are key takeaways to consider when filling out and using the DD Form 689.

• Accurate Information is Critical: Every section of the DD Form 689 must be completed with precision. This includes personal identification details like last name, first name, middle initial, organization and station, service number/SSN, and grade/rate. Inaccurate information can lead to delays or errors in receiving proper medical attention or benefits.
• Clear Documentation of Circumstances: The form requires information on whether the illness or injury occurred "In Line of Duty." This distinction is vital, as it has significant implications for an individual's medical coverage and service record. Documentation supporting the circumstances around the injury or illness should be prepared if questioned.
• Choice of Treatment Location Must Be Specified: The form allows for the indication of the disposition of the patient, whether they are to remain on duty, be sent to quarters, sick bay, hospital, not examined, or other specified locations. This decision, often made by the medical officer, determines the immediate care path for the injured or ill individual.
• Authorization by Command and Medical Officers: Signatures from both the unit commander and the medical officer are mandatory. These authorize the validity of the claim and the recommended course of action. Each signature is a critical step in the official acknowledgment of the condition and its impact on duty.
• Timeliness Matters: While the form itself does not specify a deadline, prompt completion and submission after an injury or onset of illness are imperative. Delays can complicate the administrative process and potentially affect the timely delivery of healthcare and adjustments in duty assignments.

Understanding and adhering to the directives for filling out the DD Form 689 ensures that service members receive the appropriate care and accommodations for their health needs while maintaining their service records with accuracy. It's a pivotal process in the management of military personnel's health and duties, reflecting a structured approach to maintaining an effective and healthy force.