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DA Form 7692 is a DA series document issued for use across the Department of the Army. Official title: ACTIVE DUTY FOR MEDICAL CARE APPLICATION. Purpose: active duty for medical care application. The current edition carries the date 03/01/2019 and is listed with a publication status of ACTIVE. The form runs to 2 page(s) and contains approximately 200 entry fields.
Responsibility for content and revision lies with G-1. The prescribing directive is AR 600-77, 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.
Distributed formats: PDF. The layout is common to all of them; what varies is the method of entry. The pdf is the reference version. In the fillable pdf the entry areas are live objects that accept typing; in the printable version the same areas are inert and are filled by hand after printing.
The pdf displays in current browsers and in any reader application. For fillable use a full reader is preferable to a browser viewer, since viewers vary in whether entered data is retained.
All formats are free to download and no registration is involved. The files are the published documents, distributed unmodified.
What the form asks for
- CHECK1
- CHECK10
- CHECK2
- CHECK3
- CHECK4
- CHECK5
- CHECK6
- CHECK7
- CHECK8
- CHECK9
- COMBOBOX1
- COMBOBOX10
- COMBOBOX2
- COMBOBOX3
- COMBOBOX4
- COMBOBOX6
- COMBOBOX7
- COMBOBOX8
- COMBOBOX9
- C_RANK
- ContentArea1
- ContentArea2
- DATE
- DROPDOWN2
The blocks are worked through in the order they appear on the sheet. At the head sit the identifying entries: name, identification number, unit, date. Because the filed record is indexed on these, they precede everything substantive.
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.
The signature block is the final entry, made by hand or by an authorised electronic method, and without it the document remains a draft. Countersignatures — review, approval, witness — are added in the sequence printed, dated at the moment of signing and not at preparation. Empty mandatory fields lead the list of defects; an inapplicable field is annotated as such, not passed over. Behind it come digit transposition in identification numbers, day-month inversion in dates, and residual entries surviving from a reused copy in place of a blank form.
Forms that collect personal information bear a Privacy Act statement covering authority, purpose, routine uses, and whether the disclosure is required or optional. Reading it precedes completion. Once filled, the document contains personal data and is subject to the handling and storage rules that attach to such records.
Disposition of the completed document follows the prescribing authority — delivery to the office it names, transmission through the unit administrative channel, or placement in the individual's record, according to circumstance. The preparer keeps a copy. Retention is governed by the applicable records schedule, not by office custom.
Companion forms are traced by series and number. Within the DA series, documents sharing a proponent or a governing directive are frequently required together, and a form cited on the face of another is generally submitted alongside it. Continuation sheets, covers, and transmittal forms are part of that set and are assembled in advance of submission.
An edition stands until the proponent issues a revision. The printed edition date identifies the version, and a copy held locally is checked against the edition now in force before reuse. Prior executions under a superseded edition are not reopened for that reason.
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 7692?
- ACTIVE DUTY FOR MEDICAL CARE APPLICATION
- Which edition is current?
- 03/01/2019
- Who is responsible for this form?
- G-1
- In which formats can it be downloaded?
- PDF, PDF