So what is DD Form 2499? The short answer: a Defense Department document, officially DD Form 2499, Health Care Practitioner Action Report, February 2000, used to Health Care Provider Action Report. Anything else you need follows from that.
Does it apply to your branch? Yes. The DD prefix means Department of Defense, not one service, so the same blank serves the Army, Navy, Air Force, Marine Corps, Space Force and the Coast Guard under Defense jurisdiction. There is no Army version and no Navy version to search for.
Where does the requirement come from? From not stated, with not stated responsible for the document itself. Those are the names to cite if anyone asks under what authority you filed.
How current is this? Edition not stated, publisher status not stated. That is the version described throughout this page.
What the form asks for
- 2. Type of report. Press space bar to mark X in first box if initial, second box if correction or addition, third box if revision to action, or fourth box if void previous report.
- 1. Date of report (4 digit year, 2 digit month, 2 digit day).1. Date of report (4 digit year, 2 digit month, 2 digit day, no dividers).
- 1. Date of report (4 digit year, 2 digit month, 2 digit day).3. Date of action (4 digit year, 2 digit month, 2 digit day).
- 5. Medical treatment facility (MTF). a. Name.
- b. Address (street, city, state, zip code).
- c. DMIS code.
- 6. Practitioner information. a. Name (last, first, middle).
- b. Social security number. Do not include dashes.
- 4. Effective date of action (4 digit year, 2 digit month, 2 digit day).3. Date of action (4 digit year, 2 digit month, 2 digit day).
- d. Name of professional school attended.
- X first box if in U.S., second box if foreign.
- c. Date of birth (4 digit year, 2 digit month, 2 digit day).
- e. Date graduated (4 digit year, 2 digit month, 2 digit day).
- f. Status. X first box if Army, second box if Navy, third box if Air Force, fourth box if PHS, fifth box if civilian GS, sixth box if partnership internal, seventh box if partnership external, eighth box if personnel services contract, or ninth box if non-personnel services contract.
- g. Source of accession. (1) Military. X if volunteer.
- X if Armed Forces Health Professional scholarship program.
- X if Uniformed Services University of Health Sciences.
- X if National Guard.
- X if Reserve.
- X if other.
- Specify if other.
- (2) Civilian. X if Civil Service.
- X if contracted.
- X if consultant.
Download the form
Which files are here? These: PDF. How much work is involved? 3 pages, about 147 entry fields.
What is the difference between fillable and printable? A fillable pdf has real field boxes that accept typed text and hold it inside the file. A printable pdf is a flat blank with no fields at all, intended for a printer and a pen. Which one you have determines how you complete the form, so it is worth checking first.
Should you type or write? Type, whenever the choice is yours. The reason is what happens after submission: the record gets copied and scanned, and every pass costs handwriting legibility that typed entries never lose.
What does any of this cost? Nothing. Every format listed is a free download. One practical note: save the file and open it in a desktop pdf reader, because browser previews often ignore interactive fields and lose what you typed.
Where do you start? At the top. Identification first, the substance of the entry second, certification last. Why that order? Because fields lower on the page often depend on data you established in the header, and filling out of sequence produces contradictions.
Why does the edition matter so much here? Because DD forms are revised centrally. When the Department reissues one, it reissues it for all branches simultaneously, and the field layout can shift. Compare the printed date against not stated before you type anything.
Is the form its own instruction manual? Partly. The rest sits in not stated, which is also the authority where the two texts conflict.
Who receives it? The office not stated designates, subject to whatever local instruction your organization adds. What do you keep? A copy, made before the form leaves your hands.
Do you need to know which branch issued a related form? No. DD numbering is Department-wide and unified, which means the number on its own is a complete address for the document.
Why do some instructions cite both a DA and a DD form? Because the procedure touches both systems, not because the forms are related. Service forms answer to a service proponent; DD forms answer to not stated or another Department office. The sequences were never aligned.
Why do editions change at all? Three reasons, mostly: the prescribing directive gets reissued, the information collected changes, or the required notice language is amended. Are you notified when it happens? No. Which is why confirming not stated at the moment you download is worth the few seconds.
Is any of this advice? No. This page distributes a published Defense form and explains its contents, which is a different thing from telling you whether your circumstances qualify or whether a reviewer will accept your copy. Direct questions of eligibility, applicability and procedure to not stated, to your servicing personnel office, or to the office designated in not stated.
Questions and answers
- What is DD Form 2499?
- DD Form 2499, Health Care Practitioner Action Report, February 2000
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?