DD Form 2963 Service Treatment Record (Str) Certification
What Is DD Form 2963?
DD Form 2963, Service Treatment Record Certification is a form used for indicating that a Service Treatment Record (STR) folder in an electronic record archive is complete. When archiving the STR, this record is the last document to be uploaded.
An up-to-date DD Form 2963 fillable version is available for digital filing and download below or can be found through the Executive Services Directorate website.
The information provided on the form will be forwarded to the Department of Veterans Affairs (VA) for processing potential claims and is protected under the Health Insurance Portability and Accountability Act and the Privacy Act of 1974.
The latest edition of the DD 2963 - sometimes incorrectly referred to as the DA Form 2963 - was released by the Department of Defense (DoD) in March 2014 with all previous editions being obsolete.
Download DD Form 2963 Service Treatment Record (Str) Certification
How to Fill Out DD Form 2963?
Additional guidelines and filing information and see the Department of Defense Instruction Number 6040.45 released on November 16, 2015. DD Form 2963 instructions are as follows:
- The date of certification should be specified in Block 1;
- The complete mailing address of the sender or command should be provided in Block 2;
- Block 3 is for providing personal identifying information about the service member. This includes their legal name and the last four digits of their Social Security Number (SSN) or DoD ID Number;
- Block 4 is a drop-down list with three document types to choose from. Additional comments may be provided in the space below the drop-down list, if necessary. The provided options include:
- A complete STR (Medical and Dental);
- A medical record;
- A dental record.
- Block 5 - Office of Primary Responsibility - requires information about the Office of Primary Responsibility or Point of Contact (POC). This includes the name and address of the Medical Treatment Facility (MTF) or Dental Treatment Facility (DTF), the name of the POC and the commercial number of the MTF or DTF.