DA Form 1696 Vaccine Consent and Assessment

DA Form 1696 Vaccine Consent and Assessment

What Is DA Form 1696?

This is a military form that was released by the U.S. Department of the Army (DA) on April 1, 2005. The form, often mistakenly referred to as the DD Form 1696 Specification Change Notice (Scn), 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 DA Form 1696?
A: DA Form 1696 is a Vaccine Consent and Assessment form.

Q: What is the purpose of DA Form 1696?
A: The purpose of DA Form 1696 is to provide consent and assess the readiness of individuals to receive vaccines.

Q: Is DA Form 1696 mandatory?
A: Yes, DA Form 1696 is mandatory for individuals who are required to receive vaccinations as part of their military service.

Q: Do I need to fill out DA Form 1696 if I am not in the military?
A: No, DA Form 1696 is specifically for military personnel.

Q: What information does DA Form 1696 require?
A: DA Form 1696 requires personal information, medical history, and consent for vaccine administration.

Q: Can I refuse to sign DA Form 1696?
A: While individuals have the right to refuse vaccines, refusing to sign DA Form 1696 may have consequences depending on their military obligations.

Q: Can I make changes to DA Form 1696 once it is submitted?
A: Changes to DA Form 1696 should be discussed with the relevant medical personnel or military unit.

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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 1696 down below in PDF format or browse hundreds of other DA Forms stored in our online database.

Download DA Form 1696 Vaccine Consent and Assessment

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