DA Form 5621-R - also known as the "Medical Equipment Electrical Safety" - is a United States Military form issued by the Department of the Army.
The form - often mistakenly referred to as the DD form 5621-R - was last revised on May 1, 2006. Download an up-to-date fillable PDF version of the DA 5621-R down below or look it up on the Army Publishing Directorate website.
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