4. When an individual enters active duty, who prepares his HREC?
_________________________________________________________________
5. SFC James' original Health Record cannot be located. He has an appoint-
ment to see a doctor in 15 minutes. What should the record's custodian do about a
health record?
a.
Prepare a new Health Record immediately.
b.
Give SFC James an SF 600 to give to the doctor.
c.
Give SFC James a location card to give to the doctor.
d.
Prepare a temporary record to use until the original is found.
6. A Health Record can be filed ______________________ or in_______
____________________________________________.
REQUIREMENT: For exercises 7 through 15, match the correct form number in
Column A to the correct title of the form in Column B. Place your answer in the spaces
provided to the left of Column A.
COLUMN A
COLUMN B
7. SF 600.
a. Health Record--Immunization Record.
_____ 8. SF 601.
b. Report of Medical History.
_____ 9. SF 88.
c. Health Record--Chronological Record
of Medical Care.
_____ 10. SF 93.
Identifier.
_____ 11. SF 513.
e. Disclosure Accounting Record.
_____ 12. DA Form 4515.
f. Eye Consultation.
_____ 13. DA Form 3984.
g. Dental Treatment Plan.
_____ 14. DA Form 4410-R.
h. Medical Record--Consultation Sheet.
_____ 15. DD Form 741.
i.
Report of Medical Examination.
MD0751
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