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DA Form 3696 Patient's Deposit Record
What Is DA Form 3696?
This is a military form that was released by the U.S. Department of the Army (DA) on December 1, 1977. The form, often mistakenly referred to as the DD Form 3696, 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 3696?
A: DA Form 3696 is the Patient's Deposit Record form used by the United States Army.
Q: What is the purpose of DA Form 3696?
A: The purpose of DA Form 3696 is to document and track any money or valuables deposited by a patient at a military medical treatment facility.
Q: Who uses DA Form 3696?
A: DA Form 3696 is used by patients and staff at military medical treatment facilities.
Q: What information is recorded on DA Form 3696?
A: DA Form 3696 records the patient's name, Social Security Number, date of the deposit, amount deposited, and signature of the person accepting the deposit.
Q: Why is it important to use DA Form 3696?
A: Using DA Form 3696 ensures that there is a clear record of any money or valuables deposited by a patient, which helps prevent loss or disputes later on.
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 3696 down below in PDF format or browse hundreds of other DA Forms stored in our online database.
