DAFORMFILLABLE.COM | DA FORM 4128, also known as the Patient’s Trust Fund Journal, is an essential document used in military healthcare facilities. This form, first published on June 1, 1973, remains active and plays a critical role in managing patient finances. The form is prescribed by AR 40-400, a directive from the Army Regulations.
DA FORM 4128 – Patient`s Trust Fund Journal
| Form Number | DA Form 4128 |
| Form Title | Patient` Trust Fund Journal |
| Form Date | 06/01/1973 |
| Form Proponent | TSG |
What is DA FORM 4128?
DA FORM 4128 is designed to document and manage the funds held in trust for patients at military medical facilities. It ensures that all financial transactions involving patient funds are accurately recorded and tracked. The form is used to log deposits, withdrawals, and the overall balance of each patient’s trust fund account.
Key Features of DA FORM 4128
Pub/Form Number and Date
The Pub/Form Number for the Patient’s Trust Fund Journal is DA FORM 4128. This form was published on June 1, 1973, and it remains an active document in military healthcare facilities.
Pub/Form Title
The official title of this document is Patient’s Trust Fund Journal. This title reflects the form’s primary purpose: managing and documenting patient funds.
Pub/Form Proponent
The proponent of DA FORM 4128 is TSG (The Surgeon General). This indicates that the form is under the authority and management of the Surgeon General’s office, ensuring it meets the necessary standards for medical financial management.
Prescribed Forms/Prescribing Directive
The form is prescribed by AR 40-400, which outlines the procedures and regulations for managing patient administration in Army medical facilities. This directive ensures that the use of DA FORM 4128 is standardized across all relevant military healthcare institutions.
Security Classification and Distribution
The security classification of DA FORM 4128 is UNCLASSIFIED, meaning it does not contain sensitive information that would require restricted access. The distribution restriction code is A, indicating that it is approved for public release and distribution is unlimited. This accessibility ensures that all personnel involved in patient financial management can easily obtain and utilize the form.
Importance of DA FORM 4128
Financial Accountability
The Patient’s Trust Fund Journal is crucial for maintaining financial accountability in military healthcare facilities. By documenting all financial transactions related to patient funds, the form helps prevent errors and discrepancies, ensuring that patient money is handled with the highest level of integrity.
Compliance with Regulations
Using DA FORM 4128 ensures compliance with Army regulations, particularly AR 40-400. Adhering to these regulations is essential for maintaining the trust and confidence of patients and their families in the military healthcare system.
How to Use DA FORM 4128
Recording Transactions
Each entry in the Patient’s Trust Fund Journal should be meticulously recorded. This includes noting the date, the nature of the transaction (deposit or withdrawal), the amount, and the resulting balance. Accurate record-keeping is vital to ensure transparency and accountability.
Regular Audits
Regular audits of the Patient’s Trust Fund Journal are recommended to verify the accuracy of the recorded transactions. These audits help identify and rectify any discrepancies promptly, maintaining the integrity of the patient trust funds.
Conclusion
DA FORM 4128 – Patient’s Trust Fund Journal is a pivotal tool in the management of patient finances within military healthcare facilities. Its structured format and regulatory backing ensure that patient funds are handled with care and precision. By adhering to the guidelines set forth in AR 40-400 and utilizing this form correctly, military healthcare providers can uphold the highest standards of financial accountability and patient trust.
For more detailed information and to access DA FORM 4128, visit the appropriate military or healthcare administrative resources.