Which form is this? DA Form 5223-R, official title CHILD DEVELOPMENT SERVICES (CDS) CHILD HEALTH ASSESSMENT, used to child development services (cds) child health assessment (lra). That is the whole answer in one sentence. What follows explains the version, the file and the entries.
Is this the current version? The edition offered here is dated July 1989, published with the status not stated. That date is the version number of a military form; there is no other.
Do I fill this in myself? Usually yes, unless an administrative office keeps the record for you, in which case they enter what you supply. The form itself belongs to ACSIM and is prescribed by AR 608-10. It runs to 2 page(s) and about 200 fields.
What the form asks for
- ACTIVITY
- ADMINSTR
- ADMINSTR_1
- ADMINSTR_2
- ALLERGIES
- ASTHMA_N
- ASTHMA_Y
- AUDTPROB_N
- AUDTPROB_Y
- BEDWETS
- CHICKPOX_N
- CHICKPOX_Y
- CHILD_DOB
- CHILD_NAME
- COLDS
- COMENTS
- CONSTIP
- ContentArea1
- ContentArea2
- DATE_A
- DATE_B
- DIABETES_N
- DIABETES_Y
- DIARRHEA
Download the form
What file types are offered? PDF, XFDL. The page image is the same in every one of them; only the way you complete it changes from format to format.
Fillable or printable — which do I want? Fillable, if there is a keyboard involved: the boxes are interactive objects that store text. Printable, if there is a pen involved: the boxes are just lines on paper. Nothing else distinguishes them.
Which application should I use? Reading takes nothing beyond a browser. Filling takes a proper pdf reader, since browser viewers vary in whether they retain what you type — verify with a single field and a save before you fill the whole form. What is xfdl? The IBM Lotus Forms format used inside Army systems. It requires the Lotus Forms Viewer; nothing else opens it.
Do I have to sign up? No. Every format is free, no account is involved, and the file is distributed unmodified.
Where do you start? At the top of the page, with the identifying entries: name as your official records spell it, identification number, unit or organisation, date of preparation. Why first? Because those entries are what the form is filed and searched under later, and a record indexed on a misspelled name is a record nobody retrieves.
What is the fastest way to fill the body? Tab from field to field. The order was set at build time and normally matches how the page reads, which is why tabbing catches boxes that clicking past would leave empty. And the boxes and buttons? Those take a click. Where only one option in a set can apply, choosing one deselects the other.
Can a field hold a long answer? Not if it is sized for one line — there is no wrap, and the excess prints missing while remaining visible as you type. So where does the extra text belong? In the remarks area or a continuation sheet. Should you skip fields that are irrelevant to your case? No. Mark them accordingly, because an empty field reads as an oversight rather than an answer.
Where does the signature belong in the sequence? At the very end, by hand or by an accepted electronic means. An unsigned form is a draft regardless of how full it is. Are countersignatures needed? Where the form provides for them — reviewing official, approving authority, witness — taken in printed order and dated on the day applied. What should you check before releasing it? Empty mandatory fields, digit transposition in identification numbers, day-month inversion in dates, and residue from an old copy used in place of a blank one.
What does the Privacy Act notice tell you? The legal authority behind the collection, what the information is for, the routine uses it may be put to, and whether disclosure is compulsory. When is the right moment to read it? Before completing the personal entries, at the point the statement appears. What follows from it? Your finished copy contains personal data, so store and send it the way your office handles that category.
Where do you send it? To the destination the prescribing directive names, which may be a specific office, the unit administrative channel, or the individual's file. Is a copy worth keeping? Always, and taken before submission. How long does the receiving office keep it? For the period the records schedule for the series prescribes, regardless of local custom.
What if this form is not the only one you need? Search by series and number. Within the DA series, forms under the same proponent or the same prescribing directive tend to be required as a set, and anything named on the face of one normally accompanies it. Are continuations part of that? They are, along with covers and transmittals, and all of them are collected in advance rather than after a query.
What causes a form to be superseded? A revision issued by the proponent, after which the previous edition date no longer matches the one in force. How do you check a copy you saved? Read the edition date on the page and hold it against the current edition. Must earlier submissions be redone? They must not — a completed record executed on a prior edition is unaffected.
Is this an official Department of the Army site? No. It is an independent site distributing reproductions of published Department of the Army documents for download, with no authority to issue forms. Does it guarantee acceptance of anything you submit? It does not, and nothing on the page is legal advice. Who should you ask instead? ACSIM or your servicing administrative office, whenever an entry, a requirement or your eligibility is in doubt.
Questions and answers
- What is DA Form 5223-R?
- CHILD DEVELOPMENT SERVICES (CDS) CHILD HEALTH ASSESSMENT
- Which edition is current?
- July 1989
- Who is responsible for this form?
- ACSIM
- In which formats can it be downloaded?
- PDF, XFDL