DD Form 2792 Family Member Medical Summary

Notification Icon This version of the form is not currently in use and is provided for reference only. Download this version of DD Form 2792 for the current year.

DD Form 2792 Family Member Medical Summary

What Is DD Form 2792?

DD Form 2792, Family Member Medical Summary is a form issued by the Department of Defense (DoD) and used for enrollment in the EFMP and for recording a family member's special need for medical services. This form - often confused with DA Form 2792 - was previously reviewed on August 1, 2014, with all previous editions being obsolete. An up-to-date fillable version of the form is available for download below or through the DoD Documentation website.

The information provided in the Family Member Medical Summary will help the military assignment personnel determine how the dependent's special needs may be met in accordance with the availability of medical services at a particular duty station. The form is a part of a paperwork package necessary to enroll into the Exceptional Family Member Program - or EFMP for short - and for the Family Member Travel Screening Process along with DD Form 2792-1, Special Education/Early Intervention Summary.

Despite being issued by the Department of Defense, DD Form 2792 and DD 2792-1 are required for EFMP enrollment for service members of all branches.

ADVERTISEMENT

The Exceptional Family Member Program (EFMP)

The EFMP is a program implemented by the United States Department of Defense and provides support and various services to U.S. military family members with special needs. This includes spouses, children, and dependent adults. The proper forms should be completed by a sponsor, spouse, primary care provider, or by school personnel.

EFMP enrollment is available for service members in any military branch, and each branch of service is capable of providing a wide range of medical, educational, personnel, and family support functions.

Military members enroll in the program if they have one or more family members with a diagnosed physical, intellectual, developmental, or psychological condition that needs specialized attention, medical care or educational services.

To confirm enrollment, service members need to file DD 2792 and DD 2792-1 forms and submit them with all necessary attachments to an Army Medical Treatment Facility (MTF). The EFMP Case Coordinator will then conduct an administrative review of the provided forms and forwards them to the appropriate Regional Health Command (RHC).

The RHC reviews the documents and determines eligibility. If the application is approved, the RHC downloads the data into the EFMP database on the Army Personnel Network. After that, the Case Coordinator will inform the Soldier about their successful enrollment.

DD Form 2792 Instructions

The first two pages of the form provide you with instructions for filling the form and a basic description of each of the sections.

  1. Enter the name of the Medical or Dental Treatment Facility, the Civilian provider who will be in charge of completing your enrollment or update in the fillable box on the first page of the actual form.
  2. Input the name of the family member enrolling in the program at the bottom of the same page. If you want to enroll a child, either the parent, the sponsor or an alternative guardian must provide their signature, state their relationship and date the page. If the person being enrolled is 18 and older, they must sign the form and describe their relationship status as SELF in the appropriate box.
  3. State the purpose of filing in Box 1. Provide your own personal identifying information and the information about the dependent. Then describe their medical needs in the appropriate box on page 2.
  4. Most of the third page is to be filed by administrative personnel within the EFMP. Make sure that the name of the enrollee, the name of the sponsor and the last four digits of the sponsor's SSN at the top of every page.
  5. Pages 4 through 7 are to be filled by a qualified medical professional. After your health care provider has completed the DD Form 2792, review Box 11 for accuracy. You must certify the form with your signature and date it everything is accurate and complete.
  6. Pages 8 is only applicable if the enrolled family member was diagnosed with asthma or reactive airway disease. Pages 9 and 10 are applicable only in case if the enrolled family member has a mental health diagnosis. Page 11 is only applicable if the dependent has a disorder on the autism spectrum or significant developmental delays. These pages must only be completed by a qualified care provider.

How Often Should I Update My DD Form 2792?

Enrollment should be updated every 3 years or upon any changes in the medical condition of the enrolled family member. Service members are advised to start the update process at least 90 days prior to the expiration date to ensure sufficient time for the updating process.

Where to Go to Get a DD Form 2792 Filled?

Click the link above to download a fillable copy of the DD 2792 or fill it out digitally. Alternatively, you can visit your local EFMP office and ask a Family Case Worker to provide you with a physical copy of the form or have it faxed to you.

EFMP Enrollment Forms

Army Forms for Family Member Travel Screening:

Air Force Enrollment Form:

Air Force Family Member Travel Screening Forms:

Navy forms and Marine Corps Family Member Travel Screening Forms:

Download DD Form 2792 Family Member Medical Summary

4.7 of 5 (193 votes)
  • DD Form 2792 Family Member Medical Summary

    1

  • DD Form 2792 Family Member Medical Summary, Page 2

    2

  • DD Form 2792 Family Member Medical Summary, Page 3

    3

  • DD Form 2792 Family Member Medical Summary, Page 4

    4

  • DD Form 2792 Family Member Medical Summary, Page 5

    5

  • DD Form 2792 Family Member Medical Summary, Page 6

    6

  • DD Form 2792 Family Member Medical Summary, Page 7

    7

  • DD Form 2792 Family Member Medical Summary, Page 8

    8

  • DD Form 2792 Family Member Medical Summary, Page 9

    9

  • DD Form 2792 Family Member Medical Summary, Page 10

    10

  • DD Form 2792 Family Member Medical Summary, Page 11

    11

  • DD Form 2792 Family Member Medical Summary, Page 12

    12

  • DD Form 2792 Family Member Medical Summary, Page 13

    13

  • DD Form 2792 Family Member Medical Summary, Page 1
  • DD Form 2792 Family Member Medical Summary, Page 2
  • DD Form 2792 Family Member Medical Summary, Page 3
  • DD Form 2792 Family Member Medical Summary, Page 4
  • DD Form 2792 Family Member Medical Summary, Page 5
  • DD Form 2792 Family Member Medical Summary, Page 6
  • DD Form 2792 Family Member Medical Summary, Page 7
  • DD Form 2792 Family Member Medical Summary, Page 8
  • DD Form 2792 Family Member Medical Summary, Page 9
  • DD Form 2792 Family Member Medical Summary, Page 10
  • DD Form 2792 Family Member Medical Summary, Page 11
  • DD Form 2792 Family Member Medical Summary, Page 12
  • DD Form 2792 Family Member Medical Summary, Page 13
Prev 1 2 3 4 5 ... 13 Next
ADVERTISEMENT

Video Instructions for DD Form 2792

Related Documents