What is DA Form 5569? It is the Department of the Army form titled ISONIAZID (INH) CLINIC FLOW SHEET, and it exists so that you can isoniazid (inh) clinic flow sheet. That single line covers most of what people arrive looking for. The rest of this page fills in the details.
Am I looking at the right edition? The copy here carries the date 02/01/2003 and the status ACTIVE. Forms in the DA series are identified by edition date rather than by revision number, so that date is what you compare against.
Who fills it out, and how long does it take? The individual named in the entries fills it, or a records clerk fills it on that person's behalf. Length is 1 page(s) with about 200 entry fields, which is the honest measure of the work involved. Who owns the form and when it is raised comes from TSG and AR 40-66 respectively.
What the form asks for
- ASSESM_A
- ASSESM_A_1
- ASSESM_B
- ASSESM_B_1
- ASSESM_C
- ASSESM_C_1
- ASSESM_D
- ASSESM_D_1
- ASSESM_E
- ASSESM_E_1
- ASSESM_F
- ASSESM_F_1
- ASSESM_G
- ASSESM_G_1
- ASSESM_H
- ASSESM_H_1
- ASSESM_I
- ASSESM_I_1
- ASSESM_J
- ASSESM_J_1
- ASSESM_K
- ASSESM_K_1
- ASSESM_L
- ASSESM_L_1
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.
Should I take the fillable pdf or the printable one? Take the fillable version if you will type, since its entry areas respond to the keyboard and hold what you enter. Take the printable version if you will write by hand — it is the same blank form as a flat page image. The finished result looks the same either way.
Do I need special software? Not for reading — a pdf opens in the browser you already have. For filling, install a full pdf reader rather than trusting the in-browser viewer, which sometimes displays fields it cannot save. Type into one field, save, reopen and confirm the text survived. Why will my xfdl file not open? Because it is IBM Lotus Forms, not pdf. The Lotus Forms Viewer is the only application that reads it.
Do I have to sign up? No. Every format is free, no account is involved, and the file is distributed unmodified.
Which entries come before the rest? The identifying ones at the head of the page: name, identification number, unit, date of preparation. Does it matter that they come first? Yes — everything downstream retrieves the record by those values, so they are worth getting right before you touch the substantive blocks.
How should you work through the entry fields? With the tab key. It follows the order the form was constructed in, which is usually the order the page reads, so nothing gets passed over. Do check boxes work the same way? They are clicked rather than tabbed into. In an exclusive group, a second click elsewhere clears your first choice, as intended.
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 is the Privacy Act statement on the page? A notice appearing wherever personal information is collected, setting out the authority for the collection, the purpose, the routine uses, and whether your disclosure is mandatory or voluntary. When should you read it? At the point you reach it, before entering the details it covers. And afterwards? Your completed copy holds personal data and is stored and transmitted under the rules that apply to such records.
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.
How do you find related forms? By series and number. Documents in the DA series sharing a proponent or a prescribing directive are commonly used together, and a form cited on the face of another usually goes forward with it. When should you gather them? Before submission — continuation sheets, cover sheets and transmittal documents belong in the package from the start.
When is an edition replaced? When the proponent revises the form and publishes a new edition date. What should you do with a copy kept on your own machine? Check its date against the edition in force before reusing it. Does the change reach backwards? It does not; work already completed on an earlier edition remains valid as filed.
Who publishes these files? This site does, as copies of published Department of the Army forms offered for download. Is there any official connection? None — the site is independent of the Department of the Army and issues nothing itself. Will a given office accept your document? That is not something anyone here can state, and none of this page is legal advice. Where do you take a specific question? To TSG, or to the administrative office that services your unit.
Questions and answers
- What is DA Form 5569?
- ISONIAZID (INH) CLINIC FLOW SHEET
- Which edition is current?
- 02/01/2003
- Who is responsible for this form?
- TSG
- In which formats can it be downloaded?
- PDF, XFDL, PDF
Publisher notes
- 42-ITEM ONLY PRODUCED IN ELECTRONIC MEDIA,