DAFORMFILLABLE.COM | DA FORM 4876 Fillable – Army Pubs 4876 PDF – DA FORM 4876 is an important document used by the military to manage the request and release of medical information to the communications media. This article aims to provide a comprehensive overview of the form, its purpose, and how it is utilized. By understanding the details and application of DA FORM 4876, individuals can ensure they are handling medical information requests appropriately and in compliance with military regulations.
DA FORM 4876 – Request And Release Of Medical Information To Communications Media
| Form Number | DA Form 4876 |
| Form Title | Request And Release Of Medical Information To Communications Media |
| Form Date | 04/01/2010 |
| Form Proponent | TSG |
What is DA FORM 4876?
DA FORM 4876, titled “Request And Release Of Medical Information To Communications Media,” is a form used within the military to facilitate the release of medical information to media outlets. It ensures that all requests for medical information are processed in a controlled and secure manner, maintaining the privacy and confidentiality of the individuals involved.
Key Details of DA FORM 4876
- Pub/Form Number: DA FORM 4876
- Pub/Form Date: 04/01/2010
- Pub/Form Title: REQUEST AND RELEASE OF MEDICAL INFORMATION TO COMMUNICATIONS MEDIA
- Pub/Form Proponent: The Surgeon General (TSG)
- Pub/Form Status: ACTIVE
- Prescribed Forms/Prescribing Directive: AR 40-66
- Security Classification: UNCLASSIFIED
- Distribution Restriction Code: A (Approved for public release; distribution is unlimited)
- Pub/Form IDN: 990001
- Pub/Form PIN: 080720
Purpose and Use of DA FORM 4876
The primary purpose of DA FORM 4876 is to manage the release of medical information to the communications media in a way that complies with privacy laws and military regulations. The form is crucial for ensuring that sensitive medical information is not disclosed without proper authorization and that all releases are documented appropriately.
Privacy and Compliance
One of the key aspects of DA FORM 4876 is its compliance with the Privacy Act. According to AR 340-21, a Privacy Act Statement is required to be included with the form. This statement informs the individual about their rights and the purpose of the information collection, ensuring transparency and legal compliance.
Electronic Media Production
DA FORM 4876 is produced exclusively in electronic media, making it easily accessible and efficient to use. This approach aligns with modern military practices of reducing paper usage and enhancing digital record-keeping.
How to Complete DA FORM 4876
Filling out DA FORM 4876 involves several critical steps to ensure that the release of medical information is properly authorized and documented. Here is a step-by-step guide:
Step 1: Identification of the Request
The first section of the form requires the identification details of the requestor and the specific medical information being requested. This includes the name, rank, and contact information of the individual or entity requesting the information.
Step 2: Authorization
The form must include a clear authorization from the individual whose medical information is being released. This authorization is crucial to comply with privacy regulations and to ensure that the individual is aware of and consents to the release of their medical information.
Step 3: Documentation and Signature
Finally, the form must be signed and dated by the appropriate authority. This signature confirms that the information release has been reviewed and approved in accordance with military policies and regulations.
Importance of DA FORM 4876
The use of DA FORM 4876 is vital for maintaining the integrity and confidentiality of medical information within the military. By ensuring that all requests for information are properly documented and authorized, the form helps to protect the privacy of individuals and maintain trust in the military’s handling of sensitive information.
Distribution and Accessibility
Given its unclassified status and approval for public release, DA FORM 4876 is widely accessible to authorized personnel. This broad distribution ensures that the form can be easily obtained and used whenever necessary, promoting efficient and effective information management.
Conclusion
In summary, DA FORM 4876 – Request And Release Of Medical Information To Communications Media is an essential tool for managing the release of medical information within the military. By following the guidelines and procedures outlined in the form, military personnel can ensure that they handle medical information requests in a compliant and secure manner. Understanding the purpose, use, and completion of DA FORM 4876 is crucial for anyone involved in the management of medical information in the military context.
DA FORM 4876 Fillable – Army Pubs 4876 PDF DOWNLOAD
