PDF
Word
DD Form 7A Report of Treatment Furnished Pay Patients Outpatient Furnished (Part B)
What Is DD Form 7A?
This is a form that was released by the U.S. Department of Defense (DoD) on August 1, 1976. The form, often mistakenly referred to as the DA Form 7A , 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 DoD.
FAQ
Q: What is DD Form 7A?
A: DD Form 7A is a Report of Treatment Furnished Pay Patients Outpatient Furnished (Part B).
Q: What is the purpose of DD Form 7A?
A: The purpose of DD Form 7A is to report the treatment furnished to pay patients as part of outpatient services.
Q: Who uses DD Form 7A?
A: DD Form 7A is used by medical facilities or providers that treat pay patients in an outpatient setting.
Q: What information is included in DD Form 7A?
A: DD Form 7A includes information such as the patient's name, diagnosis, treatment provided, and charges for the services.
Form Details:
- A 1-page document available for download in PDF;
- The latest version available from the Executive Services Directorate;
- Editable, printable, and free to use;
- Fill out the form in our online filing application.
Download an up-to-date fillable DD Form 7A down below in PDF format or browse hundreds of other DoD Forms compiled in our online library.
