Every entry in the Defense records system exists because some decision needed a documented basis, and DD Form 2795 is one of those instruments: DD Form 2795, Pre-Deployment Health Assessment, October 2015, created to Pre-Deployment Health Assessment. The reason it carries a DD number rather than a service designation is structural — the Department maintains a single body of forms for matters that arise identically in every service, so that a record created in one component remains intelligible in another.
That decision has consequences you will notice. Because not stated prescribes the form for the Department as a whole, and not stated maintains it on the Department's behalf, the same blank passes between the Army, the Navy, the Air Force, the Marine Corps, the Space Force, the Coast Guard when operating under Defense jurisdiction, the defense agencies and the combatant commands without translation. A clerk in one component reads a record created in another and finds the fields where they expect them.
The edition in force is not stated, carried by the publisher as not stated, and edition discipline is stricter on a Department form than most people expect, precisely because supersession happens everywhere at once. There is no interval during which one service still works from the previous layout while another has moved on.
The sequence printed on the form is the sequence in which a reviewer will read it, and the two should agree. Header data frames every entry below it; the substantive fields depend on that frame; the certification stands at the end because its whole function is to vouch for what came before. Entries made out of sequence commonly contradict entries made earlier.
Verify the printed edition against not stated first. Field structure shifts between editions, and the office that receives your record is reading the current one. That office may sit outside your service, which removes even the informal accommodation you might expect from a colleague who used the old version last month.
Every field takes an entry, N/A included. The reason is evidentiary rather than clerical: a completed record is supposed to show what was asked and what was answered, and blank space records neither. On dates, follow the format printed beside the field. Conventions vary between components, and a joint document is read by people who do not share your habits.
Understand what the Privacy Act Statement is doing on the page. It exists because collecting personal data from an individual triggers a duty to explain the collection: under what authority, for what purpose, to whom the information may routinely go, and whether you are obliged to answer. That explanation precedes the fields for the obvious reason — afterwards it is merely a notice, beforehand it is a basis for deciding.
Signature is the point at which a completed form becomes a certification, and the requirement follows from that. On paper it means ink in the designated block; electronically it means a credentialed digital signature, ordinarily applied with a Common Access Card in software that supports it. A name typed into the signature field is data, not an act — it demonstrates nothing about who entered it. The date beside the signature fixes when the certification was made, which is why a signed but undated block is treated as incomplete.
Every item on the standing defect list undermines the record in the same way — it leaves a question the file cannot answer later. Obsolete edition, empty mandatory boxes, illegible scanned handwriting, non-conforming dates, missing signature or date. Unclear entries are resolved from the printed instructions first and from not stated where the two texts diverge.
Download the form
Formats available: PDF, across 7 pages and about 200 fields.
Every format is free, as published government documents are. A note on tools, though — the interactive field layer that makes a fillable pdf useful is precisely the part browser viewers handle least reliably. Save the file, open it in a full pdf reader, and the fields behave as the form's designer intended.
What the form asks for
- Last Name
- First Name
- Middle Initial
- Social Security Number
- Today’s Date (dd/mmm/yyyy
- Date of Birth (dd/mmm/yyyy
- Gender
- Service Branch
- Component
- List
- Phone
- Cell
- DSN
- Address [1]
- Address [2]
- Address [3]
- Pay Grade
- O1
- O2
- O3
- O4
- O5
- O6
The completed form goes to the office named in not stated or in local implementing procedure, and it is worth keeping a copy before it goes. On a Department form the destination is frequently outside your own chain — another service, a defense agency, a joint staff — and recovering a document that has crossed an organizational boundary is a slower business than retrieving one from a file down the hall.
Cross-referenced documents are found by series and number, with nothing further required. That the DD sequence is unified across the Department means a cited number identifies one form and no other, which is the practical payoff of centralizing the numbering in the first place.
It helps to see the DA and DD sequences as what they are: separate registries with separate custodians. One serves a single service under a service proponent, the other serves the Department under not stated or an equivalent office, and neither was ever indexed against the other. A number that appears in both systems points to two unrelated documents, which is why reading the prefix comes before reading the digits.
Editions change for reasons that originate above the form itself. The prescribing directive is reissued and the form follows; the information the Department needs to collect changes and the fields change with it; the statutory notice language is amended and every form carrying that notice is republished. None of these events announces itself to the person who downloaded a copy last year, which is why confirming not stated at the moment of download is the only reliable check available to you.
A word on what this page is. It distributes a published Department of Defense document and describes what the document contains and how it is completed. It is not the issuing authority, does not speak for one, and offers no legal advice; nothing written here determines whether a particular submission will be accepted, because that determination belongs entirely to the office receiving it. Questions of applicability, eligibility or procedure go to not stated, to your servicing personnel office, or to the office identified in not stated.
Questions and answers
- What is DD Form 2795?
- DD Form 2795, Pre-Deployment Health Assessment, October 2015
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?