DA FORM 3984 Fillable – Army Pubs 3984 PDF

DAFORMFILLABLE.COM | DA FORM 3984 Fillable – Army Pubs 3984 PDF – In the world of military dentistry, having structured and precise documentation is crucial for maintaining the dental health of service members. DA FORM 3984, commonly referred to as the Dental Treatment Plan, is a vital document used by the United States Army to outline and record dental treatments. Established on December 1, 1972, this form serves as a comprehensive plan for both diagnosing and treating dental issues within the military community.

DA FORM 3984 – Dental Treatment Plan

Form Number DA Form 3984
Form Title Dental Treatment Plan
Form Date 12/01/1972
Form Proponent TSG

What is DA FORM 3984?

DA FORM 3984, titled Dental Treatment Plan, is an essential document used by military dental professionals. It provides a clear and organized way to document the dental care and treatment plans for service members. As an active form, it plays a critical role in ensuring that personnel receive the appropriate dental care necessary to keep them healthy and mission-ready.

Key Characteristics of DA FORM 3984

  • Publication Number: DA FORM 3984
  • Form Title: Dental Treatment Plan
  • Publication Date: December 1, 1972
  • Proponent: TSG (The Surgeon General)
  • Form Status: Active
  • Security Classification: Unclassified
  • Distribution Restriction Code: A (Approved for public release; distribution is unlimited)

Importance of DA FORM 3984 in Military Dentistry

The Dental Treatment Plan is more than just a piece of paper; it is a crucial tool that supports the dental health and operational readiness of service members. By providing a structured format for documenting dental issues and proposed treatments, DA FORM 3984 helps dental professionals maintain a consistent and efficient approach to dental care.

Benefits of Using DA FORM 3984

  • Consistency: Ensures uniform documentation of dental findings and treatments across all military dental clinics.
  • Efficiency: Streamlines the treatment planning process, making it easier for dental professionals to assess and treat service members.
  • Comprehensive Care: Helps in planning and tracking the dental treatment over time, ensuring that all necessary procedures are completed.
  • Legal and Medical Recordkeeping: Serves as an official record that can be used in medical evaluations and, if necessary, legal inquiries.

How to Use DA FORM 3984

Understanding how to properly complete and use DA FORM 3984 is essential for military dental practitioners. Here’s a step-by-step guide to using this form effectively:

Step-by-Step Guide to Completing DA FORM 3984

  1. Patient Identification: Enter the service member’s personal and medical information, including name, rank, and service number.
  2. Dental Examination Results: Document the findings from the initial dental examination, including any signs of dental diseases or issues.
  3. Treatment Plan: Outline the proposed treatments for each identified dental problem. This section should include procedures, estimated times, and any special considerations.
  4. Privacy Act Statement: Ensure compliance with privacy regulations by including a Privacy Act statement as required by AR 340-21.
  5. Authorization and Signatures: The form must be reviewed, authorized, and signed by the treating dental officer and, if applicable, the service member.

Common Questions About DA FORM 3984

Who Uses DA FORM 3984?

DA FORM 3984 is used by Army dentists, dental technicians, and other dental professionals involved in the treatment of Army personnel.

Why is the Privacy Act Statement Important?

The Privacy Act Statement (in accordance with AR 340-21) ensures that the individual’s personal data is protected and informs them of their rights regarding the use of their personal information.

How Often Should DA FORM 3984 Be Updated?

The Dental Treatment Plan should be updated whenever there is a change in the treatment plan or new dental findings that need to be documented. Regular updates ensure that the form accurately reflects the current state of the service member’s dental health.


DA FORM 3984 – Dental Treatment Plan is a foundational document in the toolkit of military dental professionals. By providing a clear framework for documenting and planning dental treatments, it contributes significantly to the health and readiness of service members. Understanding and utilizing this form effectively ensures that dental care provided within the military is both efficient and of the highest quality.

DA FORM 3984 Fillable – Army Pubs 3984 PDF DOWNLOAD

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