DA FORM 4359 Fillable – Army Pubs 4359 PDF

DAFORMFILLABLE.COM | DA FORM 4359 Fillable – Army Pubs 4359 PDF – DA FORM 4359, titled Authorization For Psychiatric Service Treatment, is a crucial document within the United States military. This form, identified by its Pub/Form Number: DA FORM 4359, was published on February 1, 2003, and remains active to date. It is a key component for authorizing psychiatric service treatment for military personnel, ensuring that proper procedures are followed in accordance with regulatory guidelines.

DA FORM 4359 – Authorization For Psychiatric Service Treatment

Form Number DA Form 4359
Form Title Authorization For Psychiatric Service Treatment
Form Date 02/01/2003
Form Proponent TSG

Purpose and Importance of DA FORM 4359

The DA FORM 4359 is designed to provide authorization for psychiatric services within the military. This form is essential for maintaining the mental health and well-being of service members, ensuring they receive the necessary psychiatric care in a timely and regulated manner. The form falls under the purview of the TSG (The Surgeon General) and is governed by AR 40-66, which prescribes its usage.

Key Features of DA FORM 4359

  • Pub/Form Title: Authorization For Psychiatric Service Treatment
  • Pub/Form Proponent: TSG (The Surgeon General)
  • Pub/Form Status: Active
  • Prescribing Directive: AR 40-66
  • Publication Date: February 1, 2003
  • Security Classification: Unclassified
  • Distribution Restriction Code: A (Approved for public release; distribution is unlimited)
  • Pub/Form IDN: 990001
  • Pub/Form PIN: 080719

Understanding the Application Process

When and Why DA FORM 4359 is Used

DA FORM 4359 is utilized when a service member requires psychiatric treatment. This form ensures that there is a formal authorization process in place, adhering to military regulations and safeguarding the service member’s health records. The AR 40-66 directive outlines the specific procedures and requirements for completing and submitting this form, which must be strictly followed to ensure compliance and proper care.

Completing DA FORM 4359

When filling out DA FORM 4359, it is important to provide accurate and detailed information to avoid any delays in treatment. The form requires information about the service member, the nature of the psychiatric services needed, and the authorization from a qualified medical officer.

Sections of DA FORM 4359

  • Personal Information: Details about the service member requiring psychiatric treatment.
  • Treatment Details: Specifics about the psychiatric services being authorized.
  • Authorization: Signatures and approvals from authorized medical personnel.

Benefits of Using DA FORM 4359

Ensuring Proper Care

By using DA FORM 4359, the military ensures that service members receive proper psychiatric care. This form acts as a safeguard, verifying that all treatments are authorized and documented in compliance with military standards.

The use of DA FORM 4359 helps in maintaining legal and regulatory compliance. It ensures that all psychiatric treatments are conducted under the guidance of AR 40-66, which stipulates the necessary protocols and procedures.

Confidentiality and Security

DA FORM 4359 is classified as unclassified, but it still maintains a high standard of confidentiality and security for the service member’s medical records. The distribution restriction code A means that it is approved for public release, but it is produced in electronic media only, as indicated by footnote 42.


DA FORM 4359 – Authorization For Psychiatric Service Treatment is a vital form within the military health system. It ensures that service members receive the psychiatric care they need while maintaining compliance with military regulations. Understanding and properly utilizing this form is essential for military medical personnel to provide the best care for their service members. By following the guidelines set forth in AR 40-66 and ensuring accurate completion, the military can uphold its commitment to the mental health and well-being of its members.

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