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DA Form 4876 Request and Release of Medical Information to Communications Media
What Is DA Form 4876?
This is a military form that was released by the U.S. Department of the Army (DA) on April 1, 2010. The form, often mistakenly referred to as the DD Form 4876, 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 4876?
A: The DA Form 4876 is a form used to request and release medical information to communications media.
Q: Who uses the DA Form 4876?
A: The DA Form 4876 is used by individuals and healthcare providers to request and release medical information to communications media.
Q: What is the purpose of the DA Form 4876?
A: The purpose of the DA Form 4876 is to authorize the release of medical information to communications media for the purpose of reporting on medical-related matters.
Q: Is the DA Form 4876 mandatory?
A: The use of the DA Form 4876 is generally not mandatory, but it may be required by certain healthcare facilities or organizations.
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 4876 down below in PDF format or browse hundreds of other DA Forms stored in our online database.
Download DA Form 4876 Request and Release of Medical Information to Communications Media
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