(6) Specific capabilities of the rotary or fixed wing aeromedical evacuation
personnel and aircraft are obtained prior to evacuation.
(7) Prior to the morning or night of the patient's departure, the nurse-in-charge
will ascertain that the last written doctor's orders, nursing notes, and nursing care plan are
attached to the DD Form 602 (Patient Evacuation Tag) and are given to the patient
evacuation clerk upon his request.
3-16. PATIENT EVACUATION SECTION RESPONSIBILITIES
The patient evacuation section, under the supervision of the AECO, receives all
requests from physicians for evacuation of patients to another MTF on the DA Form 3981
(Transfer of Patient). Once a request has been received, the Patient Evacuation Section is
responsible for all administrative actions and coordination required to accomplish the
transfer. The patient evacuation section will:
a. Review the DA Form 3981 submitted by the physician (see figure 3-2).
Physicians will specify the type and number of attendants required. When a specific
hospital in CONUS is desired, the name of an accepting physician and telephone number
is required. The GPMRC may contact the accepting physician to verify the acceptance
before authorizing the transfer.
b. Obtain all the administrative information needed to request that the GPMRC
regulate the patient. A patient evacuation worksheet is designed to record all data needed
for this request (see Section IV for suggested format). This information can be obtained
(1) DA Form 3981.
(2) The inpatient treatment record initiated at the time of admission.
(3) Interviewing the patient or family member.
c. Coordinate with the appropriate agencies to accomplish the transfer. All
CONUS evacuees are reported to the local GPMRC in accordance with local regulations.
All information required must be accurately completed.
d. Complete the DD Form 602, (Patient Evacuation Tag) (see Section III) and
obtain the physician's signature. This form is utilized as both the doctor's orders and the
patient's medical record while en route. Physicians, when signing the form, are
responsible to insure that it has been properly prepared and that the information entered is
correct. Diagnoses entered include only such detail that will be useful in caring for the
patient during evacuation. En route medication with prescribed dosage must be entered.
If a patient requires tube feeding, a copy of the feeding formula is attached. This form is