a. Initial Deposits.
(1) At the time of admission, the admissions clerk informs the patient that the
Patients' Trust Fund in available for the deposit of funds and/or valuables and that the
hospital does not assume liability or responsibility for items kept in the patient's
possession. If the patient does not wish to make a deposit, he signs the first signature
block at the top of DA Form 3696 which is retained by the custodian. If the patient wishes
to make a deposit, the following procedures are followed:
(a) The admitting clerk prepares DA Form 3696 in duplicate.
(b) The patient takes both copies of DA Form 3696 to the custodian who
enters a description of the funds and/or valuables and deposits them.
(c) The patient signs the block that he desires to make a deposit and the
custodian signs that he has received the funds and valuables on both copies. The original
is retained by the custodian and the duplicate is given to the patient as his receipt.
(2) When the deposit cannot be handled as a direct transaction between the
patient and the custodian, the deposit record (DA Form 3696) is prepared in triplicate by
the admitting clerk and all copies are signed by the patient. The responsible individual
receipts for the deposit on the triplicate copy of the deposit record and gives it to the
patient or forwards it to the intermediate individual of the professional service to which the
patient is assigned. The original and duplicate copies of the deposit record, together with
the funds and/or valuables, are taken to the custodian by the responsible individual for
deposit. The custodian checks the funds and/or valuables against the entries on the
deposit record. If the entries are correct, the custodian signs both copies of the form. The
original of the deposit is retained by the custodian and the duplicate is returned to the
responsible individual as his receipt.
(3) When the patient's signature cannot be obtained because he is unconscious
or otherwise physically unable to sign the deposit record (i.e., blind or arm amputee) or
when closed ward neuropsychiatric patients and patients under restraint for medical
reasons refuse to cooperate in the preparation of the deposit record, the above
procedures are followed except that an officer or other responsible person (in the case of a
nonmilitary patient, the sponsor or next-of-kin (NOK), if present) witness the transaction
and signs all copies of the deposit record. If necessary, the patient is searched in the
presence of a witness. A brief statement on why the patient's signature was not obtained
(e.g., "unconscious," "NP patient," etc.) is entered on the custodians' copy of the deposit
record. For nonmilitary patients, written acknowledgement is obtained on the custodian's
copy of the deposit record from the patient as soon as he is able to respond or, in the
event he continues to be incapable of signing, the sponsor or NOK in his behalf. The