DD Form 3110 Routine Immunization Screening Form: Pediatric

DD Form 3110 Routine Immunization Screening Form: Pediatric

What Is DD Form 3110?

This is a form that was released by the U.S. Department of Defense (DoD) on March 1, 2020. The form, often mistakenly referred to as the DA Form 3110 , 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 3110?
A: DD Form 3110 is a Routine Immunization Screening Form for Pediatric patients.

Q: What is the purpose of DD Form 3110?
A: The purpose of DD Form 3110 is to screen and record routine immunizations for pediatric patients.

Q: Who uses DD Form 3110?
A: DD Form 3110 is used by healthcare providers who administer routine immunizations to pediatric patients.

Q: What information is recorded on DD Form 3110?
A: DD Form 3110 records information such as the patient's name, date of birth, immunization history, and any adverse reactions.

Q: Is DD Form 3110 mandatory?
A: The use of DD Form 3110 may be mandatory for certain healthcare providers or military personnel.

Q: Can parents access DD Form 3110?
A: Parents or legal guardians of pediatric patients may request a copy of DD Form 3110 from their healthcare provider.

Q: Can DD Form 3110 be used as a proof of immunization?
A: DD Form 3110 may serve as a proof of immunization record for pediatric patients.

Q: How often should DD Form 3110 be updated?
A: DD Form 3110 should be updated whenever the pediatric patient receives a new immunization.

Q: Are there any fees associated with obtaining DD Form 3110?
A: There are typically no fees associated with obtaining a copy of DD Form 3110.

ADVERTISEMENT

Form Details:

  • A 2-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 3110 down below in PDF format or browse hundreds of other DoD Forms compiled in our online library.

Download DD Form 3110 Routine Immunization Screening Form: Pediatric

4.4 of 5 (24 votes)
  • DD Form 3110 Routine Immunization Screening Form: Pediatric

    1

  • DD Form 3110 Routine Immunization Screening Form: Pediatric, Page 2

    2

  • DD Form 3110 Routine Immunization Screening Form: Pediatric, Page 1
  • DD Form 3110 Routine Immunization Screening Form: Pediatric, Page 2
Prev 1 2 Next
ADVERTISEMENT