DA Form 5669 Preventive Medicine Counseling Record

DA Form 5669 Preventive Medicine Counseling Record

What Is DA Form 5669?

This is a military form that was released by the U.S. Department of the Army (DA) on July 1, 2012. The form, often mistakenly referred to as the DD Form 5669, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DA.

Form Details:

  • A 1-page document available for download in PDF;
  • The latest version available from the Army Publishing Directorate;
  • Additional instructions and information can be found on page 1 of the document;
  • Editable, free, and easy to use;
  • Download an up-to-date fillable DA Form 5669 down below in PDF format or browse hundreds of other DA Forms stored in our online database.

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Download DA Form 5669 Preventive Medicine Counseling Record

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  • DA Form 5669 Preventive Medicine Counseling Record, Page 1
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