Family Member Prefix
General Knowledge
Record Colors
Records Part 1
Records Part 2
100
What is the Family Member prefix for a dependent spouse/former spouse?
30-39
100
What is NAVMED 6150/21-30?
US Navy Medical Outpatient and Dental Treatment Record
100
What is the color for NAVMED 6150/20?
Orange
100
What is NAVMED 6150/7?
Health Record Receipt (Pink Card)
100
1. What form is used for the Dental Treatment Reports? 2. What form is used for the Dental Examination Reports?
1. EZ 603A 2. EZ 603
200
What is the family member prefix for civilian employees? All others?
What is the family member prefix for civilian employees? All others? 1. 98 - civilian employees 2. 99 - all others
200
Who has ultimate responsibility for medical records?
CO- patient's cannot maintain or keep their own record
200
What color is record NAVMED 6150/27?
Brown
200
What is NAVMED 6000/2?
Chronological Record of HIV testing.
200
11. What form is used for Vital Signs? 2. What is DD 877? 3. What form is used for Blood or Blood Component Transfusion?
1. SF 511 2. Request for Medical and Dental records 3. SF 508
300
What is the family member prefix for dependent father in law?
55-59
300
What is contained in Secondary records for active duty?
What is contained in Secondary records for active duty? 1. OBGYN, Family Advocacy, Psychiatry Clinic, Psychology clinic 2. Kept for Convenience 3. Contained within the MTF
300
What color is NAVMED 6150/25?
Blue
300
What is DD 2216?
Reference Audiogram
300
1. What form is used for the Dental Health Questionnaire? 2. What form is used for Progress Notes? 3. What form is used for the Adult Prevention and Chronic Care Flowsheet?
1. NAVMED 6600/3 2. SF 509 3. DD 2766
400
What is the family member for a dependent mother/stepmother? and Mother in law?
1. 40-44 - Dependent Mother/Stepmother 2. 50-54 Dependent Mother in Law
400
Where are Pencil entries made in a medical record? What does it include?
1. Made in first section of the medical record jacket in the upper left corner -Includes command and rank
400
What is the color used for medical record NAVMED 6150/24?
Tan
400
What is SF 513?
Medical Record Consultation (referral)
400
1. What is SF 519? 2. What form is used for Eyewear Prescription? 3. What is DD 2604?
1. Medical Record Radiographic Reports 2. DD 771 3. Certificate of Death
500
What is the family member prefix for dependent father or stepfather?
45-49
500
What are the three parts of preparing the medical record? List and describe each one.
Part 1: Done in pencil. Includes date of arrival, projected rotation date, home address, phone number and command UIC Part 2: Sign DD 2005 (Privacy act) in pen Part 3: Disclosure accounting record
500
What is the color for record NAVMED 6150/29?
Red
500
What is SF 545?
Laboratory Report Display
500
1. What is DD 2808? 2. What is DD 2807?
1. DD 2808- Report of Medical Examination 2. DD 2807- Report of Medical History
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