DA FORM 3365 Fillable – Army Pubs 3365 PDF

DAFORMFILLABLE.COM | DA FORM 3365 Fillable – Army Pubs 3365 PDF – In the realm of military health and safety, certain documents are pivotal for ensuring the well-being of service members. One such essential document is the DA FORM 3365, also known as the Authorization for Medical Warning Tag. This form plays a crucial role in the medical management and safety of personnel who have specific health conditions. Understanding the purpose, usage, and procedural aspects of DA FORM 3365 is vital for military medical professionals and service members alike.

DA FORM 3365 – Authorization For Medical Warning Tag

Form Number DA Form 3365
Form Title Authorization For Medical Warning Tag
Form Date 08/01/1968
Form Proponent TSG

What is DA FORM 3365?

DA FORM 3365 is a standardized form used by the United States Army to authorize the issuance of a medical warning tag to service members. This tag serves as a critical alert mechanism, informing others of the wearer’s specific medical conditions that could require immediate attention in emergency situations.

Key Features of DA FORM 3365

  • Pub/Form Number: DA FORM 3365
  • Pub/Form Date: 08/01/1968
  • Pub/Form Title: Authorization for Medical Warning Tag
  • Pub/Form Proponent: The Surgeon General (TSG)
  • Pub/Form Status: ACTIVE
  • Prescribed Forms/Prescribing Directive: AR 40-66
  • Footnotes:
    • 14 – Requires Privacy Act Statement (AR 340-21)
    • 42 – Item only produced in electronic media
  • Security Classification: UNCLASSIFIED
  • Dist Restriction Code: A (Approved for public release; distribution is unlimited)

Importance of DA FORM 3365

The DA FORM 3365 is not just a form; it is a potentially life-saving tool. It ensures that service members who have allergies, chronic conditions, or special medical needs are quickly and accurately identified in crisis situations. The medical warning tag, authorized by this form, contains vital information that can guide first responders in providing the appropriate care.

Benefits of the Medical Warning Tag

  • Quick Identification: Ensures that medical conditions are immediately known in emergencies.
  • Effective Response: Aids in providing the right medical intervention without delay.
  • Continuous Protection: Offers ongoing safety for service members both on and off duty.

How to Use DA FORM 3365

Using DA FORM 3365 involves a clear process to ensure that the medical warning tags are issued correctly and efficiently. Here’s how medical professionals and service members should approach this form:

Steps to Complete DA FORM 3365

  1. Identification of Need: A medical officer identifies a service member with a condition that requires a medical warning tag.
  2. Completing the Form: The medical officer fills out DA FORM 3365, detailing the service member’s medical condition and the specific information to be included on the tag.
  3. Privacy Act Compliance: Since the form contains personal health information, compliance with the Privacy Act (AR 340-21) is mandatory.
  4. Approval Process: The completed form is then reviewed and approved by the appropriate military medical authority.
  5. Tag Issuance: Once approved, the medical warning tag is produced and issued to the service member.

Information Included on the Tag

Typically, the medical warning tag authorized by DA FORM 3365 will include:

  • The service member’s name and ID number.
  • Specific medical condition(s).
  • Emergency contact information.
  • Any immediate medical actions required by first responders.

Who Uses DA FORM 3365?

DA FORM 3365 is utilized by a range of personnel within the military health system:

  • Medical Officers: Responsible for identifying the need and completing the form.
  • Service Members: Individuals who have or are at risk of medical conditions that could require immediate attention.
  • Health Services Support: Personnel involved in the production and distribution of the medical warning tags.
  • Emergency Responders: Benefit from the quick access to vital medical information provided by the tags.


DA FORM 3365 – Authorization for Medical Warning Tag is a critical component in the medical readiness and emergency preparedness of the United States Army. By ensuring that service members with specific health conditions are easily identifiable, this form helps safeguard the lives of those who serve. Understanding and correctly implementing the use of DA FORM 3365 can significantly enhance the effectiveness of medical interventions in urgent situations.

DA FORM 3365 Fillable – Army Pubs 3365 PDF DOWNLOAD

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