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Defense Department form, series DD, number 2852. Full title: DD Form 2852, Patient Movement Event/Near Miss Report, February 2011. Function: Patient Movement Event/Near Miss Report. Edition in force: not stated. Publisher status: not stated.
Governing directive: not stated. Responsible office: not stated. The DD designation signals joint scope — all military departments, combatant commands and defense agencies draw on a single edition of the document.
Common users: service members regardless of branch, Defense civilian staff, and the offices that file, verify or retain the finished document.
Submission follows the schedule set by not stated and by local implementing procedures. This page provides the blank form for download and general orientation only.
Available formats: PDF. The form runs 2 pages and contains approximately 118 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.
Every listed format is free to download. Modern pdf software handles the pdf files, with the caveat that browser-embedded viewers sometimes ignore field properties that a desktop reader honours.
What the form asks for
- Section I - Person completing form. 1.a. Last name.
- b. First name.
- c. Middle initial.
- d. Grade.
- e. Unit of assignment.
- f. Telephone number (include area code).
- g. Email address.
- h. Signature.
- i. Witnesses to event. (1) Name and grade, line 1.
- (2) Unit of assignment or address.
- (3) Telephone number.
- (4) Email address.
- (1) Name and grade, line 2.
- (2) Unit of assignment or address.
- (3) Telephone number.
- (4) Email address.
- j. PMQ-R generated log number (for PM safety manager).
- Section II - General information. 2. Date (4 digit year, 2 digit month, 2 digit day) and time (Z) of event.
- 3. Location of event. a. MTF.
- b. ASF or ASTS.
- c. Other R O N.
- d. En route holding area.
- e. Ground transport.
- f. Aircraft on ground.
Completion runs in the order printed on the page: identifying data at the head, the body of the entry next, certification at the foot. Header data frequently governs what belongs in the fields below it.
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.
Once executed, routing follows not stated and the submitting organization's own instruction. Keeping a copy is standard.
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.
Some procedures pair a DD form with a service form. The two numbering systems are separate — service forms answer to a service proponent, DD forms to not stated or another Department office — and a matching number in each system means nothing.
Editions change because the underlying directive changes, because collection requirements are revised, or because Privacy Act language is updated. Checking the edition date at the point of download is the practical response.
The material here is descriptive. Nothing on the page constitutes legal or procedural advice, and no statement here determines whether a submitted form will be accepted. Such questions go to not stated, a servicing administrative office, or the authority identified in not stated.
Questions and answers
- What is DD Form 2852?
- DD Form 2852, Patient Movement Event/Near Miss Report, February 2011
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?