This version of the form is not currently in use and is provided for reference only. Download this version of DA Form 3822 for the current year.
DA Form 3822, Report of Mental Status Evaluation , is a form used to document the results of a service member's behavioral health evaluation. The latest version of the form - often incorrectly referred to as the DD Form 3822 - was released by the U.S. Department of the Army (DA) on March 1, 2017 . An up-to-date DA Form 3822 fillable version can be downloaded below.
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DA Form 3822 is a document that incorporates key components required for proper diagnosis of the service member's behavioral health. It is used by Army behavioral health providers as a part of the clinical assessment process in psychiatric practice to receive a clear cross-sectional description of a service member's mental status. This document provides the behavioral service provider with a convenient and structured means to observe, analyze, evaluate, and document the patient's mental state through cognition, perception, behavior, attitude, judgment, insight, and other indications.
The DA 3822 is the only valid form that can be used by behavioral health providers within a Military Treatment Facility to document a behavioral or mental health status of a service member. It is the only document that complies with mandatory school evaluation requirements, administrative separation requirements, and command-directed evaluations. No alternative forms are authorized.
The Army policies and guidelines for use of the DA 3822 are provided in Army Regulation 40-66, Medical Record Administration and Healthcare Documentation. The form is used for:
The commander may request a mental health evaluation if the service member's words or actions arise suspect of causing injury to themselves or to others, facts and circumstances show the possibility of such injury, or the commanding officer believes the subordinates are possibly suffering from a severe mental disorder . The evaluation instructions are simple:
The provided instructions and requirements are included in the Army Reserve Psychological Health Program. The main aim of this program is to help Army leaders and units to make an informed decision regarding each case and to provide aid to service members who experience behavioral health issues.
The person responsible for conducting the Army Mental Status Evaluation is a behavioral health provider. The document consists of seven sections, and must include: