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DA Form 3647 Inpatient Treatment Record Cover Sheet
What Is DA Form 3647?
This is a military form that was released by the U.S. Department of the Army (DA) on May 1, 1979. The form, often mistakenly referred to as the DD Form 3647, 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 3647?
A: DA Form 3647 is the Inpatient Treatment Record Cover Sheet.
Q: What is the purpose of DA Form 3647?
A: The purpose of DA Form 3647 is to serve as the cover sheet for inpatient treatment records.
Q: What information is included on DA Form 3647?
A: DA Form 3647 includes information such as the patient's name, rank, social security number, date of admission, and the name of the treating physician.
Q: Is DA Form 3647 required for all inpatient treatment records?
A: Yes, DA Form 3647 is required for all inpatient treatment records in the military.
Form Details:
- A 2-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 3647 down below in PDF format or browse hundreds of other DA Forms stored in our online database.
Download DA Form 3647 Inpatient Treatment Record Cover Sheet
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