Army Forms Archive

DA Form 5188 — MEDICAL REPORT ON APPLICANT FOR CERTIFICATION TO PROVIDE CARE FOR CHILDREN OR ADULTS WITH DISABILITIES

medical report on applicant for certification to provide care for children or adults with disabilities

A newer edition of this form has been issued (02/01/2026). Download the current edition.

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DA Form 5188 belongs to the DA series of Department of the Army publications. Its official title is MEDICAL REPORT ON APPLICANT FOR CERTIFICATION TO PROVIDE CARE FOR CHILDREN OR ADULTS WITH DISABILITIES, and its stated purpose is medical report on applicant for certification to provide care for children or adults with disabilities. Edition in force: 02/01/2026. Publication status: ACTIVE. Length is 1 page(s), with roughly 93 fields available for entry.

Responsibility for content and revision lies with TSG. The prescribing directive is AR 608-75, which sets both the trigger for use and the disposition of the completed document. Entry is made by the named party or by the records clerk holding the file, with review and signature applied in the prescribed order. This edition has been superseded by a newer one. It is kept accessible for reference and for records already completed under it.

Available formats: PDF, XFDL. Each is a rendering of the same official layout; the content is identical across them and only the means of completion differs. The pdf is the reference copy. Fillable pdf carries interactive form fields; a printable pdf is the same page image without them, intended for pen entry after printing.

Any modern browser or reader will display a pdf. Interactive fields behave more predictably in a standalone reader than in an in-browser viewer, which sometimes shows fields it cannot store. An xfdl copy is published as well. It is IBM Lotus Forms, the format carried by several Army systems, and it needs the Lotus Forms Viewer; pdf readers and word processors will not open it.

All formats are free to download and no registration is involved. The files are the published documents, distributed unmodified.

What the form asks for

  • ContentArea1
  • DATE
  • DATESIGN
  • DATE_A
  • DATE_B
  • EXPLAIN_A
  • EXPLAIN_B
  • EXPLAIN_C
  • NAME
  • NO_A
  • NO_B
  • NO_C
  • Page1
  • R77
  • R78
  • R79
  • R80
  • R81
  • R82
  • R83
  • R84
  • R85
  • R86
  • R87

Entry proceeds block by block in the order printed on the page. Identifying particulars occupy the head of the form: name, identification number, unit or organisation, and date of preparation. These fields govern how the record is later retrieved from the file, so they are completed before any substantive block.

Interactive fields are filled by typing into them. Movement between fields is by tab, following the order established when the form was constructed, which usually tracks the page layout. Check boxes and radio groups are set by clicking, and exclusive groups permit one selection at a time. A one-line field has no wrap: text beyond its width prints truncated even when the screen shows it. Overlong content is placed in remarks or on a continuation, not forced into the field.

Signature comes at the end, applied in ink or by an accepted electronic method. Until it is applied the document is a draft. Additional signatures — reviewer, approver, witness — are taken in printed block order, each dated when signed rather than when the form was drafted. The commonest error is a mandatory field left blank; where nothing applies, the entry is marked accordingly instead of being skipped. Transposed identification digits, day and month reversed in dates, and carried-over data from a reused working copy account for most of the remainder.

A Privacy Act statement appears on the form where personal information is collected. It sets out the authority for collection, the purpose, the routine uses, and whether disclosure is mandatory or voluntary. The statement is read before entry, not after. Completed copies carry personal data and are handled and stored under the safeguards applicable to that data.

Once completed, the form goes where the governing authority directs: to the designated office, along the unit administrative channel, or into the personal file. The preparer retains a copy. The length of retention and the manner of filing are set by the records schedule for the series, not by local arrangement.

Related forms are found by series and number. Documents in the DA series sharing a proponent or a prescribing directive commonly travel together, and a form referenced within the body of another is usually filed with it. Continuation sheets, cover sheets, and transmittal documents belong to this group and are collected before submission rather than after.

Editions are replaced when the proponent revises the content. The edition date printed on the form is the means of telling one version from another, and the date on a downloaded copy is checked against the edition in force before use. Records already executed on a prior edition are not reworked on that account.

What is offered here are copies of published Department of the Army documents, made available for download. The site is independent of the Department of the Army and publishes no forms of its own. The material is informational and not legal advice, and no statement is made about whether any office will accept a given document. Questions of entry, requirement, or eligibility go to the proponent or the servicing administrative office.

Questions and answers

What is DA Form 5188?
MEDICAL REPORT ON APPLICANT FOR CERTIFICATION TO PROVIDE CARE FOR CHILDREN OR ADULTS WITH DISABILITIES
Which edition is current?
02/01/2026
Who is responsible for this form?
TSG
In which formats can it be downloaded?
PDF, XFDL, PDF

Other forms in the series