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Record Details For Da Form 7667 - Army Publishing Directorate: What You Should Know

The form is updated quarterly, for service members to assist in identifying gaps in the care available and to provide updates to family members when needed. The format of the form is a checkable table with a row for each medical condition being attended to. Click the row for additional information and questions. The form contains a listing of providers in alphabetical order by service member's branch of service and branch of assignment. Information is provided on the following topics: (a) medical condition, (b) treatment plan, (c) reimbursement information (e.g. amount of funds spent for care), (f) coverage by plan (such as for pay, medical, dental, vision, etc.) and (g) the plan's name and/or numbers for the service member's pay card. The form also includes the following text and images: (1) Medical condition indicated by service member; (2) treatment plan indicated by service member; (3) reimbursement information indicated by service member; (4) coverage by plan indicated by servicememember; (5) name and/or branch of service indicated by service member; (6) plan indicated by service member; (7) plan number indicated by servicememember; (8) coverage indicated by plan indicated by service member; (9) service member's medical condition as of date of submission of forms; (10) time during which forms may be submitted; (11) date the information is to be received; (12) date the information is received.

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