DA Form 4159 or the "Request For Medical Care In A Federal Medical Treatment Facility Outside Department Of Defense" is a Department of the Army-issued form used by and within the United States Military.
The form - often incorrectly referred to as the DD form 4159 - was last revised on May 1, 2009. Download an up-to-date fillable DA Form 4159 down below in PDF-format or look it up on the Army Publishing Directorate website.
Oops! This feature is under construction and will be available soon.