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DA Form 3904 Public Voucher For Medical Examination
What is DA Form 3904 Public Voucher For Medical Examination?
DA Form 3904 or the Public Voucher for Medical Examination is a form used by the US Army to reimburse service members for medical examinations conducted outside the military medical facility. This includes medical examinations conducted by civilian doctors, dentists, and other medical professionals when the service member is on leave or assigned to a duty station that does not have military medical facilities. The form is also used for reimbursement of medical expenses incurred while on temporary duty or travel orders.
The DA Form 3904 is a legal document that is used to process reimbursements for medical expenses. It is used to document the cost and nature of the medical examination and to ensure that the examination was necessary and related to military duty. The form must be completed accurately and in a timely manner to ensure that the service member receives the reimbursement that they are entitled to.
Instruction for DA Form 3904 Public Voucher For Medical Examination?
To complete the DA Form 3904, the service member or their authorized representative must provide the name and address of the medical provider, the date of the examination, the purpose of the examination, and a detailed description of the services provided. In addition, the form must include the total amount charged for the examination and any supporting documentation such as receipts or invoices.
The form must be signed and dated by the service member or their authorized representative and certified by the medical provider. The completed form should be submitted to the appropriate finance office for processing. It is important to note that the reimbursement for medical examinations is subject to certain limitations and restrictions. Service members should consult with their finance office or healthcare provider for guidance on the reimbursement process and eligibility requirements.
The Purpose of DA Form 3904 Public Voucher For Medical Examination
The purpose of the DA Form 3904 is to ensure that service members receive reimbursement for necessary medical examinations that are not available at military medical facilities. The form is used to document the cost and nature of the medical examination and to ensure that the examination was related to military duty. The reimbursement process is designed to help service members manage the cost of medical care and ensure that they are able to maintain their health and readiness for duty.
In addition to providing reimbursement for medical examinations, the form is also used to ensure that service members receive appropriate medical care while on leave or temporary duty. The form helps to ensure that the medical care provided is necessary and related to military duty and that service members are not required to pay out of pocket for expenses that are the responsibility of the military. Overall, the DA Form 3904 is an important document that helps to support the health and wellbeing of service members and ensure that they receive the necessary medical care to maintain their readiness for duty.