DA Form 3904 Public Voucher for Medical Examination

DA Form 3904 Public Voucher for Medical Examination

What Is DA Form 3904?

This is a military form that was released by the U.S. Department of the Army (DA) on August 1, 1972. The form, often mistakenly referred to as the DD Form 3904, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DA.

FAQ

Q: What is DA Form 3904?
A: DA Form 3904 is a Public Voucher for Medical Examination.

Q: What is the purpose of DA Form 3904?
A: The purpose of DA Form 3904 is to document and authorize medical examinations conducted for military personnel.

Q: Who uses DA Form 3904?
A: DA Form 3904 is used by military personnel who require medical examinations.

Q: What information is included in DA Form 3904?
A: DA Form 3904 includes personal information of the military personnel, details of the medical examination, and certification by the medical examiner.

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Form Details:

  • A 1-page document available for download in PDF;
  • The latest version available from the Army Publishing Directorate;
  • Editable, free, and easy to use;
  • Fill out the form in our online filing application.

Download an up-to-date fillable DA Form 3904 down below in PDF format or browse hundreds of other DA Forms stored in our online database.

Download DA Form 3904 Public Voucher for Medical Examination

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  • DA Form 3904 Public Voucher for Medical Examination, Page 1
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