DA FORM 3705 Fillable – Army Pubs 3705 PDF

DAFORMFILLABLE.COM | DA FORM 3705 Fillable – Army Pubs 3705 PDF – In the realm of military medical and dental documentation, DA FORM 3705 plays a crucial role. Officially titled “Receipt for Outpatient Treatment/Dental Records,” this form is an essential tool for documenting outpatient medical and dental treatments received by service members. Understanding this form is vital for healthcare professionals and administrative personnel in the military.

DA FORM 3705 – Receipt For Outpatient Treatment/Dental Records

Form Number DA Form 3705
Form Title Receipt For Outpatient Treatment/Dental Records
Form Date 01/01/1980
Form Proponent TSG

What is DA FORM 3705?

DA FORM 3705 is a standardized document used across the United States Army to record and acknowledge outpatient treatment and dental services provided to service members. The form ensures that all treatments are meticulously recorded, which is crucial for maintaining comprehensive health records and ensuring continuity of care.

Key Characteristics of DA FORM 3705

  • Publication Number: DA FORM 3705
  • Publication Date: January 1, 1980
  • Title: Receipt for Outpatient Treatment/Dental Records
  • Proponent: The Surgeon General (TSG)
  • Status: Active
  • Prescribing Directive: AR 40-66
  • Security Classification: Unclassified
  • Distribution Restriction Code: Approved for public release; distribution is unlimited

Importance of DA FORM 3705 in Military Healthcare

DA FORM 3705 is instrumental in tracking the healthcare services provided to soldiers, ensuring that all medical and dental treatments are documented. This form serves multiple purposes:

  • Ensuring Continuity of Care: By keeping detailed records, healthcare providers can offer consistent and informed care to service members, regardless of location or time.
  • Legal and Administrative Use: These records are critical for legal, administrative, and operational purposes within the military.
  • Privacy and Security: The form adheres to the Privacy Act (as indicated by footnote 14), ensuring that sensitive personal health information is handled with care.

How to Use DA FORM 3705

Understanding how to correctly fill out and use DA FORM 3705 is essential for efficient healthcare documentation in the military.

Filling Out DA FORM 3705

When completing the form, it’s important to include:

  • Service Member’s Details: Full name, rank, and service number.
  • Date of Treatment: The exact date when the treatment or service was provided.
  • Details of Treatment: A thorough description of the medical or dental treatment provided, including any medications prescribed.
  • Provider’s Information: The name and title of the healthcare provider who administered the treatment.

Key Points to Remember

  1. Complete All Required Fields: Ensure that no part of the form is left blank. This prevents misunderstandings and ensures accurate record-keeping.
  2. Use Clear, Concise Language: Avoid medical jargon where possible to make the records clear and accessible.
  3. Securely Store the Form: Once completed, DA FORM 3705 should be securely stored in the patient’s medical record.

Privacy Act Statement

Given that DA FORM 3705 involves personal health information, compliance with the Privacy Act is mandatory. The form must include a Privacy Act Statement, ensuring that all data collected is handled according to legal standards to protect the privacy of the individuals involved.

Electronic Media Production

According to footnote 42, DA FORM 3705 is primarily produced in electronic media. This shift to digital forms allows for more efficient data entry, retrieval, and storage, enhancing the overall management of health records in the military.


DA FORM 3705, the Receipt for Outpatient Treatment/Dental Records, is more than just a form; it is a vital component of the healthcare documentation process within the U.S. Army. By ensuring accurate and secure record-keeping, this form plays a crucial role in maintaining the health and readiness of service members. Understanding and correctly using DA FORM 3705 is essential for all military healthcare and administrative personnel.

DA FORM 3705 Fillable – Army Pubs 3705 PDF DOWNLOAD

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