ARMY REGULATIONS AND POLICIES PERTAINING TO OUTPATIENT
Section I. AUTHORIZED PRESCRIPTION FORMS
THE DOD PRESCRIPTION FORM (DD Form 1289)
a. Use. DD Form 1289 is to be used when only one item is prescribed for a
patient. It is the approved one item prescription form at all Army medical treatment
b. General Comments. A rubber stamp or addressograph plate may be used
on DD Form 1289 for commonly prescribed items. The prescription form must be
stamped, typed, or written in ink. Furthermore, it must be signed in ink by an authorized
prescriber. It is recommended that prescriptions originating in Army MTF be written
using the metric system. The vertical line (see figure 3-1) is considered to be a decimal
point for this purpose.
Figure 3-1. DA Form 1289.