DD Form 2813 "Department of Defense Active Duty/Reserve/Guard/Civilian Forces Dental Examination"

What Is DD Form 2813?

DD Form 2813 - Department of Defense Active Duty/Reserve/Guard/Civilian Forces Dental Examination is a form used for gathering dental information on service members about to spend an extended period of time away without of access to dental services.

The DD 2813 - or the Military Dental Form - is completed by the dental treatment facility (DTF) or civilian provider and the gathered information is stored within personnel medical files. The related Standard Form 603, Health Record - Dental can be used for the same purposes.

The examination form - often incorrectly referred to as the DA Form 2813 - was revised by the Department of Defense (DoD) on March 1, 2017. A fillable copy of the DD Form 2813 can be downloaded below or can be supplied through the chain of command.


Military Dental Form Instructions

The Government requires that all Active Duty and Reserve members receive annual dental examinations. The examination results documented on the DD 2813 Form help military physicians determine if a soldier is fit for extended service away from dental help.

The DD 2813 dental form is filled out both by the soldier receiving the dental examination and by the dentist providing it - you must bring the form with you to the examination and hand it to your doctor. Your dentist has to sign the form after the dental tests are over.

  1. Fill in your basic identifying data in Boxes 1 through 5. This includes your full name, social security number, branch of service, your unit of assignment and its address. The rest of the form will is filed by your doctor.
  2. The dentist will describe your dental condition by selecting one of the options in Box 6.
  3. In case your doctor discovers a condition that might result in an emergency in the following 12 months, they must describe it by selecting an applicable option in Box 6 (3) and give a brief written summary of the condition in Box 6 (4).
  4. Any X-rays that were performed during the examination should be marked in Box 6 (5).
  5. Boxes 7, 8 and 9 are reserved for your dentist's contact information: their full name, telephone number, address, signature and signature's license number.
  6. The doctor has to date the form in Box 10.

Army Dental Readiness Classes

The soldier is given a dental readiness class based on the results of the DD 2813 dental form. There are four readiness classes in total.

  • Class I is given to soldiers with perfect oral hygiene who are not expected to require dental treatment or re-evaluation for the next 12 months.
  • Class II is given to soldiers who have oral conditions that, if not treated or followed up, have the potential but are not expected to result in a dental emergency. These soldiers might have some history of periodontal disease but are currently in stable condition.
  • Class III is given to soldiers whose dental health is in poor condition or soldiers who have some oral conditions that are expected to result in dental emergencies within 12 months if not treated. In case of any confusion in choosing between the second and third dental readiness class, the doctor must choose the more severe of the two.
  • Class IV is given to any soldiers that have had no oral examination in the last 13 months.

Download DD Form 2813 "Department of Defense Active Duty/Reserve/Guard/Civilian Forces Dental Examination"

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Video Instructions for DD Form 2813