DD Form 2792-1 Early Intervention / Special Education Summary

The Exceptional Family Member Program (EFMP)

The EFMP is a program run by the U.S. Department of Defense. The program was designed to provide support and services to United States military family members with special needs including spouses, children, and dependent adults. Service members may enroll in the EFMP if they have a family member or family members with a diagnosed physical, developmental, intellectual, emotional, or psychological condition that requires specialized medical attention or educational services.

Individuals need a completed the DD 2792 and DD 2792-1 forms to enroll in the program. The forms should be completed by a spouse, primary care provider, or sponsor. Participation in the EFMP and access to the wide range of medical, educational, and family support functions it provides is available for servicemen of every military branch.

The completed forms are submitted to an Army Medical Treatment Facility (MTF) with all necessary attachments. The EFMP Case Coordinator reviews the provided data and forwards the forms to the appropriate Regional Health Command (RHC) who will then determine eligibility.

If the application is approved, the RHC downloads the data into the EFMP database on the Army Personnel Network and the Case Coordinator informs the Soldier of the success of the application.

DD Form 2792-1 Instructions

The first page of the form provides step-by-step instructions on how to correctly file the DD Form 2792-1. The Special Education/Early Intervention Summary is completed by the parents or sponsors of the dependent and by school personnel or early intervention staff.

Items 1 through 7 are to be filled by a spouse or a sponsor and provide the type of request and all of the necessary personal information on both the enrolled family member and the sponsor or spouse, along with the current military status, phone number, and email address.

Provide details about DEERS enrollment, the other spouse's military status, elementary or secondary education eligibility, and intervention service participation in Boxes H and I of Item 3 and Items 4, 5, and 6.

The person filing the form should date the form and certify it with their signature. The rest of the form should be completed by an EIS provider or school representative.

EFMP Enrollment Forms

1. Army Forms for Family Member Travel Screening:

   • DA Form 5888, Family Member Deployment Screening Sheet;
   • DA Form 7246, EFMP Screening Questionnaire.

2. Air Force Enrollment Form:

   • AF Form 2523, Exceptional Family Member Program - Medical Information Form (EFMP-M).

3. Air Force Family Member Travel Screening Forms:

   • AF Form 1466, Request For Family Member's Medical And Educational Clearance For Travel;
   • AF IMT Form 1466D, Dental Health Summary;
   • AF Form 4380, Air Force Special Needs Screener.

4. Navy Forms and Marine Corps Family Member Travel Screening Forms:

   • NAVMED Form 1300/1, Medical, Dental and Educational Suitability Screening for Service and Family Members;
   • NAVMED Form 1300/2, Medical, Dental and Educational Suitability Screening Checklist and Worksheet;
   • NAVMED Form 1300/16, Report of Suitability for Overseas Assignment.