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Defense Department form, series DD, number 2005. Full title: DD Form 2005, Privacy Act Statement - Health Care Records, 20151022 draft. Function: Privacy Act Statement - Health Care Records. Edition in force: not stated. Publisher status: not stated.
Issued under not stated, with not stated as proponent. A DD number marks a Department-wide instrument: the same blank form serves every military department and the defense agencies, rather than one service alone.
Common users: service members regardless of branch, Defense civilian staff, and the offices that file, verify or retain the finished document.
Timing of submission is fixed by not stated and by the implementing guidance of the submitting organization. What follows describes the blank document, not agency procedure.
Available formats: PDF. The form runs 1 pages and contains approximately 13 fillable fields.
The xfdl release corresponds to IBM Lotus Forms. This format carried Department-wide form distribution for years and opens only in IBM Lotus Forms Viewer or a compatible client, not in a pdf reader.
All formats download free of charge. Pdf files open in any modern reader; interactive fields behave most predictably in a desktop application, less so in browser viewers.
What the form asks for
- Circle1
- Page1
- SignatureField1
- T192
- T193
- T31
- Text1
- creator
- form1
- mbr_ssn
- sign_date
- title
- version
The document is filled from the top down. Identification precedes substance, substance precedes certification. Fields lower on the page are commonly keyed to entries made above them.
Verify the edition date against not stated before entry. Department-level revisions replace the blank across every service simultaneously, so an old copy in a desk drawer may no longer correspond to current field numbering.
Field-level instructions appear on the form itself and in not stated. The directive is the controlling text.
The completed document moves to the office named in not stated or in local guidance. A retained copy is conventional practice.
Cross-referenced forms are found through the numbering system. The DD sequence is Department-level and unified, which means a number cited on the page identifies one document across the whole Department.
A DD number and a DA number may appear in the same instruction without being related. DA forms belong to the Army alone; DD forms belong to the Department and are administered at Department level. The sequences are independent.
Revision occurs when the prescribing directive is reissued, when the data collected changes, or when statutory notice language is amended. Verification of the edition date at download addresses all three.
This page distributes a published Department of Defense document and describes it. It is not a source of legal advice and makes no representation about acceptance of any completed form. Questions of applicability, eligibility or procedure belong to not stated, the servicing personnel office, or the office named in not stated.
Questions and answers
- What is DD Form 2005?
- DD Form 2005, Privacy Act Statement - Health Care Records, 20151022 draft
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?