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HM Advancement > Forms > Flashcards

Forms Flashcards

1
Q

SF 601

A

Immunizations

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2
Q

NAVMED 6000/2

A

Chronological Record of HIV Testing

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3
Q

DD 771

A

Eyewear Prescription

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4
Q

NAVMED 6470/10

A

Record of Occupational Exposure to Ionizing Radiation

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5
Q

NAVMED 6470/11

A

Record of Exposure to Ionizing Radiation from Internally Deposited Radionuclide

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6
Q

DD 2493-1

A

Asbestos Exposure Part I- Initial Medical Questionnaire

Part II- Periodic Medical Questionnaire

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7
Q

OPNAVINST 5100/15

A

Medical Surveillance Questionnaire

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8
Q

DD 2005

A

Privacy Act Statement

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9
Q

SF 558

A

Medical Record- Emergency Care and Treatment Record for Ambulance Care

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10
Q

SF 513

A

Medical Record Consultation Sheet

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11
Q

DD 2161

A

Referral for Civilian Medical Care

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12
Q

DD 2604

A

Certificate of Death

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13
Q

SF 503

A

Autopsy Protocol

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14
Q

SF 523

A

Authorization for Autopsy

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15
Q

SF 523A

A

Disposition of Body

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16
Q

SF 523B

A

Authorization for Tissue Donation

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17
Q

NAVMED 6300/5

A

Inpatient Admission Disposition Record

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18
Q

SF 502

A

Narrative Summary

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19
Q

SF 539

A

Abbreviated Medical Record

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20
Q

SF 509

A

Progress Notes

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21
Q

SF 516

A

Operation Report

22
Q

SF 600

A

Chronological Record of Medical Care

23
Q

SF 517

A

Anesthesia

24
Q

SF 522

A

Request for Anesthesia

25
Q

SF 233

A

Prenatal and Pregnancy Civilian Medical Care Notes

26
Q

DD 602

A

Patient Evaluation Tag

27
Q

NAVMED 1300/1

A

Medical and Dental Overseas Screening Review for Active Duty and Dependents

28
Q

NAVPERS 1300/16

A

Report of Suitability for Overseas Assignment

29
Q

NAVMED 6100/1

A

Medical Board Report Cover Sheet

30
Q

NAVMED 6100/2

A

Medical Board Statement of Patient

31
Q

NAVMED 6100/3

A

Medical Board Certificate

32
Q

SF 78

A

Certificate of Medical Exam

33
Q

NAVMED 6120/3

A

Annual Certificate Physical Condition

34
Q

NAVMED 6150/4

A

Abstract of Service and Medical History

35
Q

DD 877

A

Request for Medical/Dental Records

36
Q

SF 515

A

Tissue Exam

37
Q

SF 519A

A

Rad Report

38
Q

SF 519B

A

Radiologic Consultation Request/Report

39
Q

SF 519

A

Medical Record- Rad Report

40
Q

SF 518

A

Blood or Blood Component Transfusion

41
Q

SF 520

42
Q

SF 524

A

Radiation Therapy

43
Q

SF 525

A

Radiation Therapy Summary

44
Q

SF 53

A

Neurological Examination

45
Q

SF 541

A

Cytology GYN

46
Q

SF 545

A

Laboratory Report Display

47
Q

SF 511

A

Vital Signs Report

48
Q

SF 512A

A

Blood Pressure Plotting Chart

49
Q

What form do you record a member MIA on?

A

SF 600 with circumstances about presumed disappearance of individual

50
Q

What do you do with a deserters record?

A

Document on SF 600, EZ 603, and Page 4 and delivered to the CO

51
Q

PHS 731

A

International Certificate of Vaccination is a personal record of Immunizations

HM Advancement (5 decks)

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