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Completing The Adult Preventive and Chronic Care Flow Sheet

In order to understand this presentation it must be viewed in Slide Show" format.. Thank you to Maj Robin M. Janke, Air Force Population Health Support Office for the original development of this presentation.Adapted for Navy by Navy Environmental Health Center PPIP Program Manager. Contact: k

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Completing The Adult Preventive and Chronic Care Flow Sheet

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    1. Completing The Adult Preventive and Chronic Care Flow Sheet DD Form 2766

    2. In order to understand this presentation it must be viewed in “Slide Show” format.

    3. DD Form 2766 A Tri-service form Used for all DoD military personnel and TRICARE Prime beneficiaries (adult only) Obtained from Navy Supply NSN 0102-LF-984-8400 http://forms.daps.mil/order/ Continuation Sheet DD2766C NSN 0102-LF-984-9600

    4. DD Form 2766 Replaced NAVMED 6150/20 (Summary of Care) in 1998 (for adults) OPNAVINST 6120.3 provides guidance on implementation of PHA (Preventive Health Assessment) Documentation face-to-face encounter not solely a record review all levels of providers use it not only privileged providers

    14. Use DD Form 2766 is now mandated by OPNAVINST 6120.3 DD Form 2766 (NSN 0102-LF-984-8400) available in packages of 100 DD 2766C (NSN 0102-LF-984-9600) available in packages of 50 from Navy Supply (stocking system) http://forms.daps.mil/order/

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