Start here if you have been told to submit DD Form 2499. First, know what you are filling: Health Care Provider Action Report. The document is titled DD Form 2499, Health Care Practitioner Action Report, February 2000.
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.
After that, turn to timing. The requirement comes from not stated; the form is maintained by not stated. Local implementing instructions fill in the dates, so check with the office that will receive your copy.
Finally, decide how you will complete it. You can type into a fillable file or print a blank and write by hand, and the rest of this page walks you through both paths in order.
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.
Your first action is verification. Find the edition date on the form and match it against not stated. A mismatch means you are working from a superseded printing, and because DD forms change Department-wide rather than service by service, the office receiving it will notice.
For questions about a specific entry, check the form's own instructions, and if that does not settle it, open not stated. The directive controls where they differ.
Download the form
First, look at what you can download. The set covers PDF, the form runs 3 pages, and you will complete roughly 147 fields.
Take the pdf if you are unsure. Then check which kind you have: if the boxes highlight when you click them, you have a fillable pdf and can type straight into it, and your entries save with the file. If nothing highlights, you have a printable pdf — send it to a printer and use black ink.
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.
What the form asks for
- 2. Type of report. Press space bar to mark X in first box if initial, second box if correction or addition, third box if revision to action, or fourth box if void previous report.
- 1. Date of report (4 digit year, 2 digit month, 2 digit day).1. Date of report (4 digit year, 2 digit month, 2 digit day, no dividers).
- 1. Date of report (4 digit year, 2 digit month, 2 digit day).3. Date of action (4 digit year, 2 digit month, 2 digit day).
- 5. Medical treatment facility (MTF). a. Name.
- b. Address (street, city, state, zip code).
- c. DMIS code.
- 6. Practitioner information. a. Name (last, first, middle).
- b. Social security number. Do not include dashes.
- 4. Effective date of action (4 digit year, 2 digit month, 2 digit day).3. Date of action (4 digit year, 2 digit month, 2 digit day).
- d. Name of professional school attended.
- X first box if in U.S., second box if foreign.
- c. Date of birth (4 digit year, 2 digit month, 2 digit day).
- e. Date graduated (4 digit year, 2 digit month, 2 digit day).
- f. Status. X first box if Army, second box if Navy, third box if Air Force, fourth box if PHS, fifth box if civilian GS, sixth box if partnership internal, seventh box if partnership external, eighth box if personnel services contract, or ninth box if non-personnel services contract.
- g. Source of accession. (1) Military. X if volunteer.
- X if Armed Forces Health Professional scholarship program.
- X if Uniformed Services University of Health Sciences.
- X if National Guard.
- X if Reserve.
- X if other.
- Specify if other.
- (2) Civilian. X if Civil Service.
- X if contracted.
- X if consultant.
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.
When DD Form 2499 references another form, search on the series and number. Because DD numbers are common to every military department, the number by itself identifies exactly one document.
Be careful when a procedure pairs this form with a service form. Read the prefix, not just the digits. Service forms answer to a service proponent, while DD forms answer to not stated or an equivalent Department office, and the two sequences were never aligned. Grabbing the wrong prefix gets you a form that has nothing to do with your task.
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 2499?
- DD Form 2499, Health Care Practitioner Action Report, February 2000
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?