DD Form 7A Report of Treatment Furnished Pay Patients Outpatient Furnished (Part B)

DD Form 7A Report of Treatment Furnished Pay Patients Outpatient Furnished (Part B)

What Is DD Form 7A?

This is a form that was released by the U.S. Department of Defense (DoD) on August 1, 1976. The form, often mistakenly referred to as the DA Form 7A , 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 DoD.

FAQ

Q: What is DD Form 7A?
A: DD Form 7A is a Report of Treatment Furnished Pay Patients Outpatient Furnished (Part B).

Q: What is the purpose of DD Form 7A?
A: The purpose of DD Form 7A is to report the treatment furnished to pay patients as part of outpatient services.

Q: Who uses DD Form 7A?
A: DD Form 7A is used by medical facilities or providers that treat pay patients in an outpatient setting.

Q: What information is included in DD Form 7A?
A: DD Form 7A includes information such as the patient's name, diagnosis, treatment provided, and charges for the services.

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Form Details:

  • A 1-page document available for download in PDF;
  • The latest version available from the Executive Services Directorate;
  • Editable, printable, and free to use;
  • Fill out the form in our online filing application.

Download an up-to-date fillable DD Form 7A down below in PDF format or browse hundreds of other DoD Forms compiled in our online library.

Download DD Form 7A Report of Treatment Furnished Pay Patients Outpatient Furnished (Part B)

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  • DD Form 7A Report of Treatment Furnished Pay Patients Outpatient Furnished (Part B), Page 1
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