Information needed on document to make the update:

Service member’s first and last name
Full SSN or Last 4 of SSN & DOB
Date of Service
Blood Type Results
Must be on Clinic or Pharmacy letterhead or Signed by the provider

FILE UPLOAD: Browse to select file to upload.

Information needed to make the update:

DD2813, SF603 form and/or dental treatment/oral exam (NAVMED) form
Service member’s first and last name
Full SSN or Last 4 of SSN & DOB
Date of Service
Dental Class
Military facility address
Provider’s signature

FILE UPLOAD: Browse to select file to upload.

Information needed on document to make the update:

Service member’s first and last name
Full SSN or Last 4 of SSN & DOB
Date of Service

FILE UPLOAD: Browse to select file to upload.

Information needed on document to make the update:

Service member’s first and last name
Full SSN or Last 4 of SSN & DOB
Date of Service
G6PD Lab Result (Normal or Deficient)
Must be on Clinic or Pharmacy letterhead or Signed by the provider

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Does the Service member have hearing aid batteries in his/her possession?
Yes
No
N/A, the Service member does not require a hearing aid

FILE UPLOAD: Browse to select file to upload.

Documentation required with provider signature
Immunization type:
Expiration Date:
Medical temporary
Medical permanent
Immune
Assumed

Is the Service member a Health Care Worker?

Yes
No

Was the Service member born in the United States?

Yes
No

FILE UPLOAD: Browse to select file to upload.

Information needed on document to make the update:

Service member’s first and last name
Full SSN or Last 4 of SSN & DOB
Date of Service
Type of immunization
Must be on Clinic or Pharmacy letterhead or Signed by the provider

FILE UPLOAD: Browse to select file to upload.

Does the Service member have required medical warning tags in his/her possession?
Yes
No
N/A, the Service member does not require medical warning tags

FILE UPLOAD: Browse to select file to upload. (optional)

Does the Service member have a 180 day supply of prescribed medication(s)?
Yes
No
N/A, the Service member does not require prescription medication(s)

FILE UPLOAD: Browse to select file to upload. (optional)

Information needed to make the update:

Service member’s first and last name
Full SSN or Last 4 of SSN & DOB
Estimated Due Date

Estimated Due Date:
Although we are able to update the 'Estimated Due Date' we are unable to update pregnancy status. We would advise you to seek assistance from your higher command.

FILE UPLOAD: Browse to select file to upload.

Information needed on document to make the update:

Service member’s first and last name
Full SSN or Last 4 of SSN & DOB
Date of Service
Sickle Cell Lab Result (Negative or Positive)
Must be on Clinic or Pharmacy letterhead or Signed by the provider

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Information needed on document to make the update:

Service member’s first and last name
Full SSN or Last 4 of SSN & DOB
Date of Service
Uncorrected and Corrected (if applicable) Binocular Distant vision scores
Uncorrected and Corrected (if applicable) Monocular Distant vision scores
Snellen fraction
If the Service member is age 44 or older, the Uncorrected and Corrected (if applicable) Binocular Near Vision scores

FILE UPLOAD: Browse to select file to upload.

RHRP Historical Updates