DA Form 2631 Medical Care - Third Party Liability Notification

DA Form 2631 Medical Care - Third Party Liability Notification

What Is DA Form 2631?

This is a military form that was released by the U.S. Department of the Army (DA) on March 1, 2000. The form, often mistakenly referred to as the DD Form 2631, 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 the DA Form 2631?
A: The DA Form 2631 is a form used for Third Party Liability Notification in medical care.

Q: What is Third Party Liability?
A: Third Party Liability refers to the responsibility of an insurance company, employer, or other party to pay for medical care expenses.

Q: When should the DA Form 2631 be used?
A: The DA Form 2631 should be used when there is a possibility of Third Party Liability for the medical care provided.

Q: Who should fill out the DA Form 2631?
A: The DA Form 2631 should be completed by the medical care provider.

Q: What information is included in the DA Form 2631?
A: The DA Form 2631 includes information about the patient, the medical care provided, and the potentially liable third party.

Q: Why is the DA Form 2631 important?
A: The DA Form 2631 is important for notifying potentially liable third parties and seeking reimbursement for medical care expenses.

Q: Are there any fees associated with submitting the DA Form 2631?
A: There are no fees associated with submitting the DA Form 2631.

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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 2631 down below in PDF format or browse hundreds of other DA Forms stored in our online database.

Download DA Form 2631 Medical Care - Third Party Liability Notification

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  • DA Form 2631 Medical Care - Third Party Liability Notification, Page 1
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