DA 7246 2009-2025 free printable template

PRINTED NAME OF MILITARY SPONSOR OR SPOUSE COMPLETING THIS FORM SIGNATURE OF MILITARY SPONSOR OR SPOUSE COMPLETING THIS FORM PRACTITIONER IF UNDER THE SUPERVISION OF A PHYSICIAN SIGNATURE OF PHYSICIAN OR MEDICAL PAGE 2 DA FORM 7246 JUN 2009. FAMILY MEMBER CONDITIONS/SERVICES YES NO REASON 3. Are any members of your family excluding service member currently receiving medical includes mental health or educational services from any providers other than a general practitioner or family practice...

How to fill out efmp

How to fill out DA 7246

1. Gather the necessary personal information, including your name, rank, and other identifying details.
2. Fill in the date and period of absence in the appropriate sections.
3. Provide specific reasons for using leave, ensuring you follow any guidelines given.
4. Complete all required sections, including signatures where indicated.
5. Review the filled-out form for accuracy before submission.

Who needs DA 7246?

1. Military personnel who require official leave or absence from duty.
2. Administrative personnel processing leave requests within the military.

Instructions and Help about efmp

This presentation is a guide to show quick tips for the DD Form 2792 for EMP make sure that you have the newest version dated August 2014 sometimes a patient will bring their forms partially completed and then ask you to complete the medical portion I find it quicker to complete the document on my computer where I can type as opposed to writing out the information if you'd prefer to complete the document on your computer simply keep the documentation that the patients have given you open a new document and ensure that the basic identification information is filled out for a patient named patient sponsor and social security number generally this information will auto-populate on the remaining pages and turn both copies into your EMP case coordinator and the rest can be merged by them if you prefer to complete your documentation on your computer I recommend that you complete a template for yourself simply fill out your provider name and contact information and save use this template for future documentation purposes and remember to save as a new file with each new patient if this is an EMP update then the patient will likely have prior documentation the launch tool EMP office is currently trying to upload the previous documentation into the late note under the Haynes application h aims you may also contact your FOP case coordinator and ask them for a printout referred to as per net PE net the per net documentation will include all prior diagnosis you must address all diagnoses on your updated EMP form you may remove a diagnosis, but it must be stated on the updated documentation the per net information can be helpful in your update to keep the information consistent if there's been no changes the new EMP file from August 2014 can be signed electronically which allows us to send these documents electronically as long as it's encrypted note that each section that as medical documentation must be signed by the completed medical provider once you've completed the diagnosis the icd-10 code medications and the number of visits that were required for the diagnosis give a brief synopsis of the primary diagnosis and treatment plan in this box if there are alternates that are particularly helpful you are encouraged to reference those in this box as well if you have questions about how to complete this form please reference other videos or call your local EMP case coordinator for further guidance you may obtain your / net documentation from your EMP case coordinator

People Also Ask about

How do I start the EFMP process?

EFMP Enrollment: Soldiers initiate enrollment in EFMP by contacting their nearest Army Medical Treatment Facility EFMP case coordinator. Participants in the EFMP are enrolled permanently in the program unless medical or special education needs warrant case closure or the Soldier is separated from the Army.

What are the EFMP categories?

There are six Navy EFMP enrollment categories: • Category I – for monitoring purposes only. • Category II - pinpoint to specific geographic locations. • Category III - no overseas assignments. • Category IV - major medical areas in CONUS. homestead location. Category V - •

Who fills out EFMP paperwork?

Every Navy Military Treatment Facility (MTF) appoints an EFMP Coordinator to facilitate the enrollment process. Coordinators provide enrollment forms, offer help in the preparation of the forms, review completed forms for accuracy, and forward the enrollment package to the Central Screening Committee (CSC) via NFAAS.

What qualifies you for EFMP?

An Exceptional Family Member is a Family member with any physical, emotional, developmental, or intellectual disorder that requires special treatment, therapy, education, training, or counseling, and meets the eligibility criteria.

How long does it take for EFMP to get approved?

The EFMP process can take up to 14 business days.

What are the qualifying conditions for EFMP?

Have serious or chronic medical problems, physical disabilities, mental health disorders or require intensive follow-up support or early educational/special education services. further follow-up) • Cerebral Palsy or Loss of Mobility (requiring use of wheelchair, walker etc.)

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What is DA 7246?

DA 7246 is a Department of the Army form used for the purpose of requesting leave or pass for military personnel.

Who is required to file DA 7246?

All military personnel who are requesting leave or a pass are required to file DA 7246.

How to fill out DA 7246?

To fill out DA 7246, provide personal information such as name, rank, unit, the type of leave or pass requested, dates, and reason for the leave or pass.

What is the purpose of DA 7246?

The purpose of DA 7246 is to formally document and request permission for military personnel to take leave or a pass.

What information must be reported on DA 7246?

DA 7246 must report the individual's name, rank, unit, dates of leave or pass, type of leave or pass, and the reason for the request.