Dont Screw Up My Disability

Question 1

What provisions determine the standards for handling health records?

Answer 1

HIPAA, Privacy Act of 1974, FOIA

Question 2

What form is the Health Record Receipt?

Answer 2

NAVMED 6150-7

Question 3

When completing the DD-2808 what are the appropriate entries for Not Evaluated, Not Indicated and Not Applicable?

Answer 3

NE (items 17-42), NI, NA

Question 4

Who endorses item 44 on the 2808?

Answer 4

Approving Official

Question 5

Form number for Medical Board Report Cover Sheet?

Answer 5

CG-5684

Question 6

This form provides a current, concise and comprehensive record of a member’s medical history.

Answer 6

SF-600

Question 7

What form number is the International Certificate of Vaccine?

Answer 7

PHS-731 or CDC-731

Question 8

What is the CG-5214?

Answer 8

Emergency Medical Treatment Report

Question 9

Who receives Parts I, II and III of the CG-5214

Answer 9

Part I - Copy to patient record
Part II - Copy to Receiving Unit
Part III - Copy to Triage Officer (Mass Cas Incidents)

Question 10

This form shall be used whenever an individual receives emergency treatment which cannot be documented in the electronic health record SF-600

Answer 10

SF-558 Emergency Care and Treatment

Question 11

This form provides a multiple copy record of all emergency medical care rendered by CG personnel outside of a clinic or sickbay

Answer 11

CG-5214 Emergency Medical Treatment Report

Question 12

This is the Eyewear Prescription Form?

Answer 12

DD-771

Question 13

This form is prepared and inserted in the health record for each person for whom a confirmed diagnosis of syphilis or any of its complications or sequela has been established

Answer 13

Serology Record SF-602

Question 14

Patients sign this form prior to administration of anesthesia

Answer 14

Request for Administration of Anesthesia and Performance of Operations and Other Procedures OF-522

Question 15

When is the OF-522 not required?

Answer 15

Routine dental anesthesia (Ch 4)

Question 16

What is form CG-4057

Answer 16

Chronological Record of Service

Question 17

When is the CG-4057 used?

Answer 17

1 - As a statement of agreement or disagreement with the assumption of fitness for duty upon separation from the CG
2 - To terminate the health record
3 - Notification of benefits

Question 18

What is form DD-2870

Answer 18

Authorization for Disclosure of Medical or Dental Information

Question 19

What is DD-2871?

Answer 19

Request to Restrict Medical or Dental Information (used between units/clinics, MTFs)

Question 20

What is the NAVMED 6600-3?

Answer 20

Dental Health Questionnaire

Question 21

What is the SF-603?

Answer 21

Dental Record

Question 22

What is the SF-603A

Answer 22

Dental Continuation

Question 23

Guidance for the safe keeping of records is contained in what manual?

Answer 23

CIM 5260.2 USCG Freedom of information Act and Privacy Acts Manual

Question 24

What is the email address for reporting inpatient status?

Answer 24

HQS DG HSWL Inpatient Hospitalization

Question 25

How long are IMRs kept on file?

Answer 25

Retained at the creating health care facility for six years after the date the patient is released from overnight care. Then forward to NPRC

Question 26

How long is a master list of IMRs forwarded to NPRC kept on file?

Answer 26

50 years

Question 27

Active Duty episodic visits or routine appointment will be recorded on what form for Mental Health?

Answer 27

SF-600