Start here if you have been told to submit DD Form 2005. First, know what you are filling: Privacy Act Statement - Health Care Records. The document is titled DD Form 2005, Privacy Act Statement - Health Care Records, 20151022 draft.
Next, check the edition. You want not stated, currently carried as not stated by the publisher. Then confirm the form applies to you — this is a Department of Defense form, so you use it whether you serve in the Army, Navy, Air Force, Marine Corps, Space Force or Coast Guard under Defense jurisdiction.
Then settle the schedule. You are working under not stated, with not stated responsible for the document, and your organization layers its own deadlines on that. Ask before you assume a date.
Last in this stage, choose your method: complete it on screen, or print the blank form and fill it out in pen. The sections below take each route step by step.
Begin at the top and move down. Enter your identifying data first, then the body of the form, then the signature block. The sequence is printed in that order because entries below frequently follow from entries above.
Check the edition before you type a word. The date appears on the face of the form; it should read not stated. When it does not, discard the file and take a fresh copy from this page. Department-level revisions replace the blank across all services simultaneously, which means an old printout can be out of step everywhere.
If a particular field puzzles you, read the instructions printed on the form first, then go to not stated. When the two disagree, follow the directive.
Download the form
Step one is picking the format. You have PDF to choose from, across 1 pages, with approximately 13 fields to complete.
Choose pdf as your default. Next, click inside a box. A fillable pdf responds by outlining the field and letting you type; the text stays in the document when you save it. A printable pdf does not respond, which tells you to print the page and complete it by hand.
Prefer typing over writing. Your form will likely be scanned and emailed onward, and typed text reproduces at every stage while pen strokes fade or blur. When you do write, print in capitals so the receiving clerk can read it.
Handle xfdl in two steps. First confirm you have IBM Lotus Forms Viewer or a compatible reader on your machine; ordinary pdf software will report the file as broken. Once the viewer is running, download and fill the form.
You will not be charged for any of these; the whole set is free. Before you start entering data, save the file to your computer and open it there. Fields behave far more reliably in a desktop reader than in a browser preview.
What the form asks for
- Circle1
- Page1
- SignatureField1
- T192
- T193
- T31
- Text1
- creator
- form1
- mbr_ssn
- sign_date
- title
- version
Now that it is complete, send it where not stated or your local procedure says it goes. Before you do, make yourself a copy — scan it or save the file elsewhere. It costs you nothing and saves you the whole exercise if the original goes missing.
If the form points you to another document, you can find it by number alone. DD numbering runs across the whole Department, so you do not need to work out which service issued it — one number, one form, everywhere.
Watch out for one trap here. If your instructions cite a DA form as well, do not assume the numbers are connected. DA numbering belongs to the Army alone; DD numbering belongs to the Department and is administered by not stated or another Department office. The same number in each system means two unrelated forms, so read the prefix before you download.
Come back and check the edition next time you need this form. Editions change when the prescribing directive is reissued, when the information collected changes, or when the required notice language is updated, and none of those events reaches you directly. Verifying not stated at the moment you download is the whole defence.
Before you go, note what is not covered here. You have the blank form and instructions for completing it; you do not have legal guidance, and no statement on this page determines what any office will do with your submission. Direct those questions to not stated, to the personnel office that serves you, or to the office designated in not stated.
Questions and answers
- What is DD Form 2005?
- DD Form 2005, Privacy Act Statement - Health Care Records, 20151022 draft
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?