DD Form 877 Request for Medical / Dental Records or Information

DD Form 877 Request for Medical / Dental Records or Information

What Is DD Form 877?

This is a form that was released by the U.S. Department of Defense (DoD) on September 1, 1967. The form, often mistakenly referred to as the DA Form 877 , 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 877?
A: DD Form 877 is a request form for medical/dental records or information.

Q: Who can use DD Form 877?
A: Any person who needs to request medical/dental records or information can use DD Form 877.

Q: How do I fill out DD Form 877?
A: You need to provide your personal information, the specific information or records you are requesting, and sign and date the form.

Q: How long does it take to receive the requested records or information?
A: The processing time can vary, but it usually takes several weeks to receive the requested records or information.

Q: Are there any fees for requesting medical/dental records or information using DD Form 877?
A: There may be fees associated with the request, such as copying or mailing fees. The specific fees can vary, so contact the military medical facility for more information.

Q: Can I request someone else's medical/dental records using DD Form 877?
A: No, you can only request your own medical/dental records or information using DD Form 877. For someone else's records, you may need to follow a different process.

Q: What should I do if I need additional assistance or have questions about DD Form 877?
A: If you need additional assistance or have questions, contact the military medical facility where you are submitting the form. They will be able to provide you with the necessary guidance.

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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 877 down below in PDF format or browse hundreds of other DoD Forms compiled in our online library.

Download DD Form 877 Request for Medical / Dental Records or Information

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  • DD Form 877 Request for Medical / Dental Records or Information, Page 1
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