Military Forms Guide

DA Form 5190 — CLINICIAN`S INFORMATION

clinician`s information

A newer edition of this form has been issued (02/01/2026). Download the current edition.

Administrative documents are written for readers who were not present, and DA Form 5190 is no exception. Titled CLINICIAN`S INFORMATION, it is used to clinician`s information — a transaction that means little in conversation and a great deal in a file. The published edition here carries the date 02/01/2026 and the status ACTIVE. Its 2 page(s) and roughly 128 fields are sized to what the record must prove years later, which is always more than the moment appears to need. A newer edition exists. This one is retained because the documents completed on it were completed under its terms and are read under them.

Two offices stand behind the form, and the distinction between them explains most of what follows. TSG is the proponent: it decides what the form asks and revises it when the underlying process changes. AR 608-75 is the prescribing authority: it decides when the form is raised at all and where the completed document travels. Content and occasion are separated deliberately, so that a change in procedure does not require redesigning the page.

Retrieval governs the order of entry. The head of the form takes name, identification number, unit and date, and those values become the handles by which the record is found later — the substantive blocks are never searched on. This is why the spelling must match official records exactly rather than approximately.

Much of the form's behaviour follows from its being a fixed page. Tab order was set at build time along the reading sequence, which is why tabbing catches boxes a pointer passes over. Exclusive groups release one choice when another is made because a record cannot carry two answers to a single question. Single-line fields refuse to wrap because every entry must print where the layout expects it — text beyond the width is lost at the margin, visible on screen to the end. That is what remarks areas and continuation sheets are for. Marking a field that does not apply matters for a related reason: emptiness is ambiguous, and a reviewer reading the file later cannot distinguish an omission from a decision.

The signature is the point at which entries become an assertion someone stands behind, so it follows everything else and its absence leaves a draft. Countersignatures by reviewing, approving or witnessing officials each carry their own weight and are dated at signing, which is how the file preserves the order of responsibility. Seen that way, the familiar errors are not clerical trivia: an unanswered mandatory field, digits transposed in an identification number, day and month reversed, and residue from a reused file each put something false or unresolved into a document that will be relied upon.

Personal information may not be gathered silently, and the Privacy Act statement is how that obligation is met on paper: it names the collection authority, the purpose, the routine uses and whether disclosure is mandatory. Because it exists to inform a decision, it belongs before the fields it covers rather than after them. A filled copy then holds personal data and is stored and transmitted under the corresponding safeguards.

Download the form

The published formats — PDF, XFDL — reflect the range of places a form gets filled in. Where there is a computer, the fillable pdf supplies live fields that keep entries positioned and readable. Where there is not, the printable pdf gives the identical page as flat artwork for pen entry. The distinction is one of setting rather than of authority; the page is the same document in both.

Software determines whether an entry lasts. A browser viewer is designed for reading, and several will take typed input into fields without any means of writing it back — the text is simply absent when you reopen. A standalone reader handles the form structure properly. The xfdl file is IBM Lotus Forms, carried in Army systems for the routing and signature support it provides, which is why the Lotus Forms Viewer is its only reader.

There is no charge and no sign-up. Published documents are distributed as published, without modification.

What the form asks for

  • ADDRESS
  • BIRTHDATE
  • CARE_NEED
  • CARE_NEED_1
  • CARE_NEED_10
  • CARE_NEED_11
  • CARE_NEED_2
  • CARE_NEED_3
  • CARE_NEED_4
  • CARE_NEED_5
  • CARE_NEED_6
  • CARE_NEED_7
  • CARE_NEED_8
  • CARE_NEED_9
  • ContentArea1
  • DATE_A
  • DATE_B
  • NAME
  • OTHER2
  • PHYSICIAN
  • Page1
  • Page2
  • R45
  • R46

Disposition is prescribed, not chosen. AR 608-75 names the destination, whether that is a specific office, the unit administrative channel or the personal record, and the applicable records schedule governs how long it survives there. Both rules exist to keep the file consistent across offices with different habits. Take your copy before the document leaves, since it will not come back.

Related documents are located by series and number, and the relation is rarely accidental — forms under one proponent or one directive tend to serve steps of a single procedure. Anything the DA series form names on its face normally travels with it, as do the continuations, covers and transmittals the process generates. Assembling them together is what makes the submission a complete account.

An edition marks the form at a point in a process that keeps moving, and the date printed on the page is what distinguishes one from another. Since a saved file never announces its own obsolescence, compare its date against the current edition before using it again. Prior executions remain valid: the change applies forward, and a record is read against the edition it was written under.

One boundary should be stated clearly. What is distributed here are copies of published Department of the Army forms; the site is independent, issues nothing of its own, and holds no position in the system it describes. Proponency, prescribing directives and retention schedules operate without reference to it. Consequently nothing here is legal advice and no assurance about acceptance is possible. Questions about a particular entry, a requirement or eligibility belong with TSG or your servicing administrative office.

Questions and answers

What is DA Form 5190?
CLINICIAN`S INFORMATION
Which edition is current?
02/01/2026
Who is responsible for this form?
TSG
In which formats can it be downloaded?
PDF, XFDL, PDF

Other forms in the series