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DD Form 2164 X-Ray Verification / Certification Worksheet
What Is DD Form 2164?
This is a form that was released by the U.S. Department of Defense (DoD) on November 1, 1978. The form, often mistakenly referred to as the DA Form 2164 , 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 2164?
A: DD Form 2164 is the X-Ray Verification/Certification Worksheet.
Q: What is the purpose of DD Form 2164?
A: The purpose of DD Form 2164 is to verify and certify the results of X-Ray examinations.
Q: Who uses DD Form 2164?
A: DD Form 2164 is used by individuals or organizations performing X-Ray examinations.
Q: What information is included in DD Form 2164?
A: DD Form 2164 includes information such as the patient's name, date of examination, X-Ray equipment used, and the results of the examination.
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 2164 down below in PDF format or browse hundreds of other DoD Forms compiled in our online library.
Download DD Form 2164 X-Ray Verification / Certification Worksheet
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