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DA 7246 2009-2024 free printable template

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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...
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How to fill out efmp form

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How to fill out EFMP:

01
Start by obtaining the EFMP application form from the appropriate military department or branch.
02
Fill out the applicant's personal information section, including name, contact information, and military affiliation.
03
Provide detailed information about the medical, educational, and special needs of the family member requiring EFMP enrollment.
04
Attach any relevant medical or educational documentation, such as diagnosis reports or individualized education programs (IEPs).
05
If applicable, indicate the need for specific medical services or equipment required for the family member's well-being.
06
Complete the family history section, including information about previous enrollments in EFMP or other similar programs.
07
Ensure all signatures and authorizations are provided where required.
08
Once completed, submit the EFMP application to the designated office or department for review and processing.

Who needs EFMP:

01
EFMP is typically required for military servicemembers who have dependent family members with diagnosed medical, educational, or special needs.
02
It helps ensure that appropriate support services and resources are available at the servicemember's duty station.
03
Family members requiring ongoing medical treatments, therapy, special education, or assistive devices may benefit from EFMP enrollment.
04
EFMP helps ensure that the military can meet the unique needs of individuals with disabilities and provides necessary support for their families.

Video instructions and help with filling out and completing efmp

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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

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1. Gather the necessary documents: You will need to provide copies of your service member's most recent performance evaluations, medical records, and deployment records, if applicable. 2. Log into the Enrollment System: Visit the EFMP website and log in. 3. Complete the Enrollment Form: Fill out the online form with the required information. 4. Submit Your Documents: Upload the documents you collected earlier. 5. Receive a Confirmation Email: Once the enrollment process is complete, you will receive an email with a confirmation number. This number can be used to track the status of your enrollment. 6. Follow Up with Your Command: Make sure to contact your command and inform them of your enrollment. They may have additional forms or information that needs to be completed.
The Exceptional Family Member Program (EFMP) is a Department of Defense (DoD) program designed to provide comprehensive and coordinated community support, housing, educational, medical, and personnel services to families with special needs. It is designed to assist military families in accessing needed services and support, as well as provide resources and support to military families who have a family member with special needs. The program is intended to help military families maintain their quality of life when caring for a family member with a special need.
There is no penalty for late filing of EFMP. However, if filing is delayed for an extended period of time, a service member may be ineligible for certain assignments or deployments. It is important to remember that EFMP is a voluntary program and the service member has the option to opt out at any time.
EFMP stands for Exceptional Family Member Program. It is a program administered by the United States military to support military personnel who have family members with special needs. The program ensures that the necessary support and resources are available to assist families with members who have medical, educational, or other special need requirements. The main objective of EFMP is to help military families maintain a suitable environment for the well-being of all family members, including those with special needs.
The primary beneficiary of a military service member is required to file EFMP (Exceptional Family Member Program) paperwork. This includes family members who have a medical, mental health, or educational condition that requires special attention or support. Additionally, the service member themselves may also be required to file EFMP paperwork if they have a condition that affects their deployment status or assignment.
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