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IMPRINT OR TYPE PATIENT DATA (Same as items 2 thru 28, DA Forms 3647, 3647-1 or its equivalent) 2. HOME ADDRESS (Include ZIP code) AND TELEPHONE NUMBER (Non-military patients) 3. RECOVERY JUDGE ADVOCATE. 4. NAME AND ADDRESS OF FACILITY SUBMITTING NOTIFICATION ... DA FORM 2631, MAR 2000

MEDICAL CARE - THIRD PARTY LIABILITY NOTIFICATION Foruseofthisform,seeAR40-400;theproponentagencyistheOTSG ITEMSMAYBECONTINUEDONREVERSE(Identifybyitemnumber)

DA Form 2631, also known as the Medical Care-Third Party Liability Notification, plays a pivotal role in the process of healthcare cost recovery. This article provides a comprehensive overview of DA Form 2631, detailing its purpose, use, and significance within the military healthcare system.

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DA Form 2631-R, Medical Care--Third Party Liability Notification. - Patient Affairs Branch. DA Form 2631-R, Medical Care--Third Party Liability Notification - Patient Affairs Branch: Figure 2-3. DA Form 3154, MSA Invoice and Receipt. - Patient Affairs Branch: Patient Affairs Branch

2023年9月21日 · Downloading Army da Form 2631 is a fundamental step for service members requiring this specific document. By providing a downloadable version of da Form 2631, the Army facilitates quick and efficient access to this essential tool.