How to Fill out DD Form 771?
No filling guidelines are distributed with the form by the DoD. DD Form 771 instructions are as follows.
- The date of filing - along with the account number and order number - are specified in the corresponding sections at the top of the page. The laboratory address and the sender's information should be placed in Sections labeled "To" and "From";
- The form continues with self-explanatory sections specifying the patient's data (their name, SNN, grade, address, and phone number). No Army or Field Post Office addresses may be given. It is also necessary to identify the recipient of the order. Orders can be received by the clinic or by the patient;
- The further sections identify the parameters of the ordered eyewear and are completed according to the patient's needs. The minimum information to be filled in includes pupillary distances, axis (when the cylinder box is provided) and segment height for bifocals;
- The "Special Comments" section is for clarifying the information if the sections titled "Other" are filled in;
- The prescribing officer or authority inserts their name and signature at the bottom of the page. A copy of the form will be brought with the completed order and another copy wil be kept with the patient's health record.