DD Form 877

Requests from military medical facilities for health and/or clinical records are submitted on a DD Form 877.

General information:  Treatment facilities usually request the following types of records.

• Health Records:  Outpatient treatment while on active duty.  Usually filed in the military personnel or medical record (check for a NPRC registry number or if prior to 1964 pre-registry meds).  Recent records are filed at Veterans Administration Records Management Center (VARMC ).
• Military Retiree Outpatient:  Outpatient treatment after veterans retire from the military.  Usually filed in the Organizational Records Section.  Recent records (within 2 years) may still be at the treatment facility.  Name of last treatment facility, last year treated, vet’s name and SSN/SN needed for search.
• Clinical (Inpatient):  Records of hospitalization.  Usually filed in the Organizational Records Section.  Name of treatment facility, year treated, vet’s name, and patient’s name, and SSN needed for search.  Recent records (within 2 years) may still be at the treatment facility.  Note:  AF & Army dependents are at CPR.

Core Employees:

• Carefully read the information on Records Requested in blocks 8a and 9.
• Furnish copies of exactly what information is requested; do not furnish additional information.
• Do not send originals.  Furnish copies only of any health and/or clinical information requested.

1. Complete the Reply/Referral section (blocks 11 through 14).
2. Check the appropriate boxes regarding Records Forwarded (block 8b).
3. Retain a copy of the completed form in the OMPF.
4. Forward the completed DD Form 877, and copies of requested records to the requestor’s address provided in block 19.

If the requested records are not at NPRC and their present location is unknown:  Inform the requestor that the requested records are not on file.  Check the appropriate box in block 12 of the DD877

If the requested records are not at NPRC and their present location is known (as shown in examples below).

1. Inform the requestor of the location of the records.
2. Retain a copy of the DD Form 877 in the OMPF.

   • Health record retired to the Department of Veterans Affairs (DVA) Records Management Center on or after the following dates:

     Air Force:	May 31, 1994
     Army:	October 16, 1992
     Navy:	January 31, 1994
     Marine Corps:	May 1, 1994
     Coast Guard:	April 1, 1998

   • Clinical record still at treating facility (clinical not yet retired to NPRC)
   • Health or clinical record loaned to VA.

OR Technicians:

General Information:  Request are from Medical Treatment facilities, often the treatment facility that retired the records to NPRC.  The Treatment Facilities usually request the following types of records.

• Military Retiree Outpatient:  Outpatient treatment after veterans retire from the military.  Usually filed in the Organizational Records Section.  Recent records (within 2 years) may still be at the treatment facility.  Name of treatment facility, last date treated, vet’s name and SSN needed for search.
• Clinical (Inpatient):  Records of hospitalization.  Usually filed in the Organizational Records Section.  Name of treatment facility, year treated, vet’s name and SSN needed for search.  Recent records (within 2 years) may still be at the treatment facility.

General processing of the DD Form 877:

1. Furnish original records.
2. Complete the Reply/Referral section (blocks 11 through 14).
3. Check the appropriate boxes regarding Records Forwarded (block 8b).
4. Retain a copy of the completed form in the OMPF (if available) and the Clinical or Outpatient record.
5. Forward the completed DD Form 877, and requested records to the medical treatment facility (only) address provided in block 19.

Source:  NPRC 1865.103