First, confirm you are on the right form. DA Form 4006 carries the official title FIELD MEDICAL RECORD JACKET, and you use it to field medical record jacket. Second, check the edition: the copy offered here is dated 02/01/1979 and its publication status is ACTIVE. Third, size up the job — unknown page(s) and about unknown entry fields, so you can decide whether to fill it now or set aside time.
Then work out your role. If the entries describe you, you fill them in and someone in the administrative section checks the result. If you handle records for others, you enter what they supply and pass the form along. In both cases the same two references govern you: TSG maintains the form, and AR 40-66 sets out the trigger for using it and the route it takes. Read that directive before you start when anything about your case is unusual.
Begin with the first block and follow the printed order. You will enter your name first, exactly as your official records show it, followed by your identification number, your organisation, and the date of preparation. Resist the urge to jump to the substantive blocks and return to the header later. Those first entries are the index for the whole record, and an error there costs you the ability to retrieve it.
Now for the body. Use tab to advance through the fields; the order was set when the form was built and following it keeps you from leaving gaps. Check boxes and option buttons take a click. Where the options are mutually exclusive, choosing one will clear another, which is how the group is meant to behave. As you type longer entries, watch the field edge. One-line fields do not wrap, and anything past the edge prints missing even when you can still read it on screen — when that happens, put the text in remarks or on a continuation sheet. Leave nothing blank because it does not apply; enter the mark that means it does not apply, so the reviewer knows you read the question.
Save the signature for last. Sign by hand, or by whatever electronic method your office accepts, and understand that until you do the document is a draft no matter how complete it looks. If the form calls for a reviewing official, an approving authority, or a witness, take those signatures in the order the blocks print, and have each signer date it on the day they sign rather than the day you prepared it. Before you hand it over, read it once more from the top. You are looking for three things in particular: a mandatory field you left empty, digits transposed in your identification number, and a date written with day and month the wrong way round. Check one more thing if you built this form from a copy you had lying around — old entries survive in a reused file, and they will go forward as though you meant them.
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
Then choose a file to download. What you will see offered is none published here, and the only question you need to answer is whether you are typing or writing. Type, and you want the fillable pdf, where the entry areas respond to your keyboard. Write, and you want the printable pdf, which you print empty and complete with a pen. The layout does not change between them, so pick whichever fits how you plan to work today.
Once the file is on your machine, open it deliberately. A pdf will usually launch in your browser, which reads well enough but does not always hold what you type; certain viewers display the fields and then discard your entries. Save the download to a folder, open it from there in a dedicated reader, and test one field and one save before you commit to filling the whole thing.
Finally, note what the download costs you: nothing. You do not create an account, you do not enter an email address, and the file you receive is the published document with nothing added to it.
With the form signed, send it where AR 40-66 tells you to send it — usually to the office it names, or through your unit administrative channel, or straight into your own record, depending on why you raised it. Keep a copy for yourself before it leaves your hands. How long the receiving office holds it is not your decision or theirs; the records schedule for the series settles that, and local habit does not override it.
When another document has to travel with this one, find it by series and number. Forms in the DA series sharing a proponent or a governing directive are commonly used in combination, and anything cited on the face of your form generally goes with it. Assemble continuation sheets, covers and transmittals before you send the package rather than in response to a query.
The next time you open this form from your own files, check the edition date first. Revisions come from the proponent without warning to you, so the only reliable step is to hold your copy against the current edition before filling it in again. Records you already completed under a superseded edition stand, and you do not go back to rework them.
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 4006?
- FIELD MEDICAL RECORD JACKET
- Which edition is current?
- 02/01/1979
- Who is responsible for this form?
- TSG
- In which formats can it be downloaded?
- No file published here