First, confirm you are on the right form. DA Form 3611-R carries the official title FOOD SERVICE DIVISION-PATIENT SATISFACTION SURVEY (LRA), and you use it to food service division-patient satisfaction survey (lra). Second, check the edition: the copy offered here is dated 06/01/1970 and its publication status is ACTIVE. Third, size up the job — 1 page(s) and about 57 entry fields, so you can decide whether to fill it now or set aside time.
Now decide who does the writing. Normally you enter your own particulars, then hand the sheet to the unit administrative office for review. If you work in that office, you enter what the individual brings you. From there the path is the same for everyone: TSG is responsible for the form, and TM 8-504 tells you what triggers it and where it ends up. Look at the directive first whenever your case departs from the ordinary.
Start at the top of the page and work down. The heading blocks come first: write your name as it appears on your official records, then your identification number, then your unit or organisation, then the date you are preparing the form. Do not skip ahead to the interesting parts and come back — these heading entries are how your form is found in the file afterwards, and a form filed under a misspelled name is a form nobody can locate.
Once you reach the body of the form, move between fields with the tab key rather than the mouse; it follows the order the form was built in and you are less likely to skip a box. Click check boxes and option buttons directly. When you meet a group of options where only one can apply, notice that selecting a second one clears the first — that is intended, not a fault. Watch your longer answers as you type them. A single-line field does not wrap, so text that runs past the edge stays visible on screen and then prints cut off. When you see that happening, stop and move the text to the remarks area or a continuation instead of squeezing it in. If a field does not apply to you, mark it rather than leaving it empty; a blank space tells the reviewer nothing about whether you considered the question or missed it.
Leave the signature until everything else is done. Sign by hand or by an approved electronic means, and remember that a form without a signature is a draft, however complete the entries. Where a second and third signature are required — reviewing official, approving authority, witness — go in the order the blocks appear, and each signer dates the form on the day of signing. Then go back to the top and read what you wrote. Look first for a mandatory field you passed over, then for transposed digits in your identification number, then for a date with the day and month inverted. If you started from a file you had used before, look also for entries left from that earlier use; nothing removes them but you.
You will find a Privacy Act statement on the form wherever personal information is collected. Read it at that point rather than skipping past it, because it tells you the authority for the collection, the purpose, the routine uses, and whether answering is mandatory. After you fill the form, remember that your copy contains personal data. Store it and transmit it as your office requires for records of that kind.
Download the form
Now pick your file. You have PDF, XFDL to choose from, and the choice depends on one thing: whether you will type the entries or write them by hand. Choose the fillable pdf when you want to type, tab between fields and keep a clean copy on your computer. Choose the printable pdf when you intend to print the blank first and write on paper. The pages look identical either way, so you are not giving anything up by picking the wrong one — you are only choosing how you work.
Then take care with how you open what you downloaded. Your browser will happily display a pdf, and for reading that is enough — but for typing it is not, because some in-browser viewers accept keystrokes and then throw them away when the tab closes. Put the file somewhere on disk, open it in a proper reader, type into one field and save, and confirm the text is still there when you reopen. If you picked up the xfdl copy, get the IBM Lotus Forms Viewer before you go any further, because nothing else will open the file.
One last point before you move on: every format is free. No registration stands between you and the file, and what you download is the published form, unaltered.
What the form asks for
- COMMENTS
- ContentArea1
- FOOD_ITEMS
- NO_A
- NO_B
- NO_C
- NO_D
- NO_E
- Page1
- R54
- R55
- R56
- R57
- R58
- R59
- R60
- R61
- R62
- R63
- Rectangle1
- SUGGESTION
- T24
- T25
- T26
Once you have signed, route the form. The prescribing directive names the destination: an office, your unit administrative channel, or your personal file, according to the case. Make yourself a copy first, because you will not get the original back. After that, retention is out of your hands — the applicable records schedule fixes how long the document is kept, whatever the practice in a particular office.
Should the package need more than one document, search by series and number. Within the DA series, forms under the same proponent or the same prescribing directive tend to be required as a set, and a form referenced on the page you are filling usually accompanies it. Collect the continuations, covers and transmittals up front so the submission goes complete the first time.
Check the edition date again the next time you reach for this form. Editions change when the proponent revises the content, and a copy you saved months ago may no longer be current — compare the date printed on your file against the edition in force before you type anything into it. What you do not need to do is redo work already finished: a form you completed and submitted under an earlier edition stays as it is.
Read this before you go. The file you download is a reproduction of a published Department of the Army document, offered as it was published. We are an independent site with no connection to the Department of the Army and no authority to issue anything, and we make no statement about whether your completed form will be accepted anywhere. Treat what you read here as information, not legal advice. Take real questions — about an entry, a requirement, or your eligibility — to TSG or to your servicing administrative office.
Questions and answers
- What is DA Form 3611-R?
- FOOD SERVICE DIVISION-PATIENT SATISFACTION SURVEY (LRA)
- Which edition is current?
- 06/01/1970
- Who is responsible for this form?
- TSG
- In which formats can it be downloaded?
- PDF, XFDL, PDF
Publisher notes
- 41-ITEM ALSO PRODUCED IN ELECTRONIC MEDIA