Start here if you have been told to submit DD Form 2911. First, know what you are filling: DoD Sexual Assault Forensic Examination Report\n \n Download Suspect Instructions \n Download Victim Instructions \n. The document is titled DD Form 2911, DoD Sexual Assault Medical Forensic Examination Report, September 2015.
Then look at the edition date: not stated, publisher status not stated. After that, ask whether the form covers your situation. It almost certainly does regardless of your branch — DD forms run Department-wide rather than through a single service.
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.
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.
Start at the header. Complete your identification before anything else, then work through the main entries, then finish at the certification. Skipping around causes contradictions between the top of the form and the bottom.
Before your first entry, look at the corner of the page and compare the printed date with not stated. If they do not match, stop and download again. Old copies circulate in shared drives for years, and a DD form is revised centrally for every service at once, so a superseded blank may not carry the fields your reviewer expects.
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 15 pages, and you will complete roughly 200 fields.
Whichever you pick, you pay nothing — every format here is a free download. One last tip: open your pdf in a desktop reader rather than in a browser tab, because browser viewers sometimes drop the interactive fields you need.
What the form asks for
- A. General Information. Name of medical facility:
- 1a. Name of patient (last, first, middle initial).
- 1b. Patient ID number.
- 2a. Address (street and apartment number).
- 2b. City.
- 2c. County.
- 2d. State.
- 2e. Zip code.
- f. Telephone (include area code). (1) Home.
- (2) Work telephone number.
- 3.a. Age.
- b. Date of birth: 4 digit year, 2 digit month, 2 digit day, no separators.
- c. Gender. Press space bar to mark X in first box if male, second box if female.
- d. Ethnicity. X first box if Hispanic or Latino, second box if not.
- e. Race (X all that apply). Mark X if American Indian/Alaska native.
- Mark X if Asian.
- Mark X if black or African American.
- Mark X if white.
- 4.a. Arrival date (4 digit year, digit month, 2 digit day).
- b. Arrival time.
- 5.a. Discharge date (4 digit year, digit month, 2 digit day).
- b. Discharge time.
- B. Notification and authorization. Location of assault. X first box if on installation, second if off installation.
- Jurisdiction: X first box if city, second box if county, third box if other.
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 2911 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.
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.
Do not archive this file and reuse it in a year. Forms are reissued as directives are revised, as data requirements shift, and as statutory notice text is amended. Your protection is simple: download fresh each time and confirm the edition date.
One thing this page does not do: tell you whether your submission will be accepted. We publish the document and explain how to complete it, and that is where our role ends. Nothing here is legal advice. Take questions about eligibility, applicability or procedure to not stated, to your servicing personnel office, or to the office named in not stated.
Questions and answers
- What is DD Form 2911?
- DD Form 2911, DoD Sexual Assault Medical Forensic Examination Report, September 2015
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?