DA Form 3711 Army Substance Abuse Program (Asap) Resource and Performance Report (Rapr)

DA Form 3711 or the "Army Substance Abuse Program (asap) Resource And Performance Report (rapr)" 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 3711 - was last revised on November 1, 2001. Download an up-to-date fillable DA Form 3711 down below in PDF-format or look it up on the Army Publishing Directorate website.

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ARMY SUBSTANCE ABUSE PROGRAM (ASAP) RESOURCE AND PERFORMANCE REPORT (RAPR)
REQUIREMENTS CONTROL
SYMBOL: CSGPA-1291
For use of this form, see DA PAM 600-85; the proponent agency is ODCSPER
1. NAME AND ADDRESS OF SUBMITTING ORGANIZATION
2. SERVICE AREA CODE
3. REPORT PERIOD (Month, Year)
SECTION I - POPULATION SERVED
4. PERSONNEL ASSIGNED, ATTACHED, OR SUPPORTED BY AGREEMENT
ACTIVE DUTY
INACTIVE DUTY
ACTIVE DUTY FOR
CIVILIAN
MINOR FAMILY
OTHER
ACADEMY CADETS
RETIRED MILITARY FAMILY MEMBERS
PERMANENT PARTY
TRAINEES
TRAINING
EMPLOYEES
MEMBERS
PERSONNEL
SECTION II - URINALYSIS TESTING OF MILITARY PERSONNEL
SECTION III - MILITARY/CIVILIAN EDUCATION AND TRAINING
a. PRESCREEN TEST RESULTS
NUMBER
TOTAL
TOTAL
INSPECTION
OTHER THAN INSPECTION
LINE
TYPE OF CLASS
OF
NUMBER OF
NUMBER
LINE TYPE OF DRUG
CLASSES
STUDENTS
CLASS HOURS
POSITIVE
NEGATIVE
POSITIVE
NEGATIVE
1
THC
1
Commander and Staff Training
2
Cocaine
2
Civilian Employee Supervisor Training
3
Amphetamines
3
Unit Prevention Education
4
Barbiturates
4
Community Prevention Education
Alcohol/Drug Prevention Training
5
PCP
5
(ADAPT)
6
Opiates
6
Other Prevention Education
7
Other
7
Total
REMARKS
b. PRESCREENED AND NOT SENT TO THE LAB
UNIT
REASONABLE
REHAB
PHYSICIAN
OTHER
TOTAL
INSPECTION
SUSPICION
PATIENT
DIRECTED
AUTHORIZED
AUTHENTICATION
5. TYPED NAME AND GRADE OF INDIVIDUAL AUTHENTICATING REPORT
6. SIGNATURE
7. DATE (YYYYMMDD)
DA FORM 3711
NOV 2001
DA FORM 3711-R, NOV 1991 IS OBSOLETE
APD LC v1.01ES
,
ARMY SUBSTANCE ABUSE PROGRAM (ASAP) RESOURCE AND PERFORMANCE REPORT (RAPR)
REQUIREMENTS CONTROL
SYMBOL: CSGPA-1291
For use of this form, see DA PAM 600-85; the proponent agency is ODCSPER
1. NAME AND ADDRESS OF SUBMITTING ORGANIZATION
2. SERVICE AREA CODE
3. REPORT PERIOD (Month, Year)
SECTION I - POPULATION SERVED
4. PERSONNEL ASSIGNED, ATTACHED, OR SUPPORTED BY AGREEMENT
ACTIVE DUTY
INACTIVE DUTY
ACTIVE DUTY FOR
CIVILIAN
MINOR FAMILY
OTHER
ACADEMY CADETS
RETIRED MILITARY FAMILY MEMBERS
PERMANENT PARTY
TRAINEES
TRAINING
EMPLOYEES
MEMBERS
PERSONNEL
SECTION II - URINALYSIS TESTING OF MILITARY PERSONNEL
SECTION III - MILITARY/CIVILIAN EDUCATION AND TRAINING
a. PRESCREEN TEST RESULTS
NUMBER
TOTAL
TOTAL
INSPECTION
OTHER THAN INSPECTION
LINE
TYPE OF CLASS
OF
NUMBER OF
NUMBER
LINE TYPE OF DRUG
CLASSES
STUDENTS
CLASS HOURS
POSITIVE
NEGATIVE
POSITIVE
NEGATIVE
1
THC
1
Commander and Staff Training
2
Cocaine
2
Civilian Employee Supervisor Training
3
Amphetamines
3
Unit Prevention Education
4
Barbiturates
4
Community Prevention Education
Alcohol/Drug Prevention Training
5
PCP
5
(ADAPT)
6
Opiates
6
Other Prevention Education
7
Other
7
Total
REMARKS
b. PRESCREENED AND NOT SENT TO THE LAB
UNIT
REASONABLE
REHAB
PHYSICIAN
OTHER
TOTAL
INSPECTION
SUSPICION
PATIENT
DIRECTED
AUTHORIZED
AUTHENTICATION
5. TYPED NAME AND GRADE OF INDIVIDUAL AUTHENTICATING REPORT
6. SIGNATURE
7. DATE (YYYYMMDD)
DA FORM 3711
NOV 2001
DA FORM 3711-R, NOV 1991 IS OBSOLETE
APD LC v1.01ES
,
1. NAME AND ADDRESS OF SUBMITTING ORGANIZATION
2. SERVICE AREA CODE
3. REPORT PERIOD (Month, Year)
SECTION IV - CIVILIAN EMPLOYEE URINALYSIS TESTING
PERSONS CONFIRMED BY MRO
ASAP ACTION
PERSONNEL ACTION
PER-
NUMBER
ITEMS
SONS
POSITION
ENROLLED
TERM-
RE-
IN
TESTED
THC COC AMP OPI PCP HAL BAR
OTHER REFERRED REFUSED
RTD REASSIGN
COMPLETED
INATED
SIGNED
REHAB
1
TDP Random
1A
Aviation
1B
Guard/Police
1C
PRP
1D
ASAP
Other Designated
1E
Positions
2
Reasonable Suspicion
Safety, Mishap,
3
Accident
4
Rehabilitation Patient
5
Volunteer
6
TOTAL
SECTION V - CIVILIAN EMPLOYEE PRE-HIRE TESTING
REMARKS
APPLICANTS
PERSONS CONFIRMED BE MRO
TESTED
ITEMS
FED
NON-FED
THC
COC
AMP
OPI
PCP
HAL
BAR
OTHER
1A
Aviation
1B
Guard/Police
1C
PRP
1D
ASAP Staff
Other Designated
1E
Positions
6
TOTAL
DA FORM 3711, NOV 2001
Page 2 of 3
APD LC v1.01ES
1. NAME AND ADDRESS OF SUBMITTING ORGANIZATION
2. SERVICE AREA CODE
3. REPORT PERIOD (Month, Year)
SECTION VI - MANPOWER UTILIZATION
CON-
ASSIGNED
BORROWED
INDIRECT WORK
TRACTOR
LINE
MAN-
MAN-
CATEGORIES
MAN-
PERFORMANCE FACTOR
CON-
HOURS
HOURS
DIRECT MISSION
ASSIGNED
BORROWED
HOURS
LINE
TRACTOR
PERFORMANCE
MANHOURS
MANHOURS
MANHOURS
2A
Supervision
2B
Administration
TITLE
AMOUNT
2C
Meetings
1A
Biochemical Testing (Drug)
Tests
2D
Staff Training
1B
Biochemical Testing (Alcohol)
Tests
2E
Supply etc
1C
Prev. Education (Drug)
Students
1
1D
Prev. Educatio (Alcohol)
Students
Subtotal Direct Mission
1E
Treatment (Drug)
Visits
Subtotal Indirect Work
2
Categories
1F
Treatment (Alcohol)
Visits
1G
Staff Training (Drug)
Classes
Other than ASAP Mission
3
1H
Classes
Staff Training (Alcohol)
1I
Program Evaluation (Drug)
Assessments
4
Total Manpower Utilized
1J
Program Evaluation (Alcohol)
Assessments
SECTION VII - MANPOWER STAFFING AND FINANCIAL DATA
MILITARY PERSONNEL
CIVILIAN EMPLOYEES
ORGANIZATION
CONTRACTOR
DOLLARS OBLIGATED
MISSION
PERSONNEL
LINE
BY PROGRAM
REQUIRED
AUTHORIZED
ASSIGNED
REQUIRED
AUTHORIZED
ASSIGNED
AREA
ASSIGNED
Drug
1
Biochemical Testing
Alcohol
Drug
2
Prevention Education
Alcohol
Drug
3
Treatment
Alcohol
Drug
4
Staff Training
Alcohol
Drug
5
Program Evaluation
Alcohol
6
Total
COMBINED
REMARKS
Page 3 of 3
DA FORM 3711, NOV 2001
APD LC v1.01ES

Download DA Form 3711 Army Substance Abuse Program (Asap) Resource and Performance Report (Rapr)

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