FORM_TYPE |
META |
Type of Form |
POST |
ADMIN |
Exact Match (all same field name)
|
FORM_VERSION |
META |
DoD Form Version |
DD2796_202312 |
ADMIN |
Exact Match (all same field name)
|
LNAME |
DEM |
Last Name |
Text Field |
DEMOGRAPHICS |
Exact Match (all same field name)
|
FNAME |
DEM |
First Name |
Text Field |
DEMOGRAPHICS |
Exact Match (all same field name)
|
MI |
DEM |
Middle Initial |
Text Field |
DEMOGRAPHICS |
Exact Match (all same field name)
|
DODID |
DEM |
DoD ID number (formerly EDIPI) |
9999999999 |
IDENTITY |
Primary Join Key
|
D_EVENT |
DEM |
Today's Date (date on form) |
YYYYMMDD |
DEPLOYMENT |
Semantic Match – All 3 Schemas
|
DOB |
DEM |
Date of Birth |
YYYYMMDD |
DEMOGRAPHICS |
Exact Match (all same field name)
|
SEX |
DEM |
Sex |
M=Male, F=Female |
DEMOGRAPHICS |
Semantic Match – All 3 Schemas
|
FORM_SERVICE |
DEM |
Service Branch |
F=Air Force, A=Army, N=Navy, M=Marine Corps, S=Spa |
DEPLOYMENT |
Semantic Match – All 3 Schemas
|
SERVICE_OTHER |
DEM |
Other Defense Agency |
Text Field |
DEPLOYMENT |
Exact Match (all same field name)
|
FORM_COMPONENT |
DEM |
Component |
A=Active Duty, N=National Guard, R=Reserves, X=Civ |
DEPLOYMENT |
Exact Match (all same field name)
|
GRADE |
DEM |
Pay Grade |
E01=E1, E02=E2, E03=E3, E04=E4, E05=E5, E06=E6, E0 |
DEMOGRAPHICS |
Semantic Match – All 3 Schemas
|
GRADE_OTHER |
DEM |
Other Grade |
Text Field |
DEMOGRAPHICS |
Exact Match (all same field name)
|
UNIT_NAME |
DEM |
Unit Name |
Text Field |
DEMOGRAPHICS |
Exact Match (all same field name)
|
UNIT_LOC |
DEM |
Duty Station/Location |
Text Field |
DEMOGRAPHICS |
Exact Match (all same field name)
|
PHONE |
DEM |
Current Phone |
Text Field |
DEMOGRAPHICS |
Semantic Match – All 3 Schemas
|
CELL |
DEM |
Current Cell Phone |
Text Field |
DEMOGRAPHICS |
Exact Match (all same field name)
|
DSN |
DEM |
Current DSN |
Text Field |
OTHER |
Exact Match (all same field name)
|
EMAIL |
DEM |
Current Email |
Text Field |
DEMOGRAPHICS |
Exact Match (all same field name)
|
ADDR |
DEM |
Current Address |
Text Field |
DEMOGRAPHICS |
Exact Match (all same field name)
|
CITY |
DEM |
Current CITY |
Text Field |
DEMOGRAPHICS |
Exact Match (all same field name)
|
STATE |
DEM |
Current STATE |
Text Field |
DEMOGRAPHICS |
Exact Match (all same field name)
|
ZIP |
DEM |
Current ZIP Code |
Text Field |
DEMOGRAPHICS |
Exact Match (all same field name)
|
POC_NAME |
DEM |
POC Name |
Text Field |
OTHER |
Exact Match (all same field name)
|
POC_PHONE |
DEM |
POC Phone |
Text Field |
OTHER |
Exact Match (all same field name)
|
POC_EMAIL |
DEM |
POC Email |
Text Field |
OTHER |
Exact Match (all same field name)
|
POC_ADDR |
DEM |
POC Address |
Text Field |
OTHER |
Exact Match (all same field name)
|
POC_CITY |
DEM |
POC CITY |
Text Field |
OTHER |
Exact Match (all same field name)
|
POC_STATE |
DEM |
POC STATE |
Text Field |
OTHER |
Exact Match (all same field name)
|
POC_ZIP |
DEM |
POC ZIP Code |
Text Field |
OTHER |
Exact Match (all same field name)
|
D_ARRIVAL |
DEM |
Date arrived theater |
YYYYMMDD |
DEPLOYMENT |
Semantic Match – DD2796 & ANAM
|
D_DEPART |
DEM |
Date departed theater |
YYYYMMDD |
DEPLOYMENT |
Unique to DD2796
|
COUNTRY1 |
DEM |
Country 1 |
Text Field |
DEPLOYMENT |
Semantic Match – DD2795 & DD2796
|
COUNTRY1_MONTHS |
DEM |
Time at location (months) |
00-99 |
DEPLOYMENT |
Unique to DD2796
|
COUNTRY2 |
DEM |
Country 2 |
Text Field |
DEPLOYMENT |
Unique to DD2796
|
COUNTRY2_MONTHS |
DEM |
Time at location (months) |
00-99 |
DEPLOYMENT |
Unique to DD2796
|
COUNTRY3 |
DEM |
Country 3 |
Text Field |
DEPLOYMENT |
Unique to DD2796
|
COUNTRY3_MONTHS |
DEM |
Time at location (months) |
00-99 |
DEPLOYMENT |
Unique to DD2796
|
COUNTRY4 |
DEM |
Country 4 |
Text Field |
DEPLOYMENT |
Unique to DD2796
|
COUNTRY4_MONTHS |
DEM |
Time at location (months) |
00-99 |
DEPLOYMENT |
Unique to DD2796
|
COUNTRY5 |
DEM |
Country 5 |
Text Field |
DEPLOYMENT |
Unique to DD2796
|
COUNTRY5_MONTHS |
DEM |
Time at location (months) |
00-99 |
DEPLOYMENT |
Unique to DD2796
|
HEALTH_ASSESSMENT |
1 |
Overall, how would you rate your health during the PAST MONTH? |
E=Excellent, V=Very Good, G=Good, F=Fair, P=Poor |
OTHER |
Exact Match (all same field name)
|
HEALTH_CHANGE |
2 |
Compared to before deployment, how would you rate your health in general now |
1=Much better now than when I deployed 2=Somewhat |
OTHER |
Unique to DD2796
|
HEALTH_CHANGE_WORSE1 |
2 |
Somewhat worse now than before I deployed (please explain) |
Text Field |
OTHER |
Unique to DD2796
|
HEALTH_CHANGE_WORSE2 |
2 |
Much worse now than before I deployed (please explain) |
Text Field |
OTHER |
Unique to DD2796
|
TOBACCO_USE |
3 |
How often did you smoke tobacco (for example cigarettes, cigars, pipe, or hookah |
0=Not at All 1=Some Days 2=Just about every day |
OTHER |
Unique to DD2796
|
INJURED |
4 |
Were you wounded, injured, assaulted or otherwise hurt during your deployment? |
Y=Yes, N=No, blank=missing |
OTHER |
Unique to DD2796
|
INJ_PROB |
4 |
If yes, are you still having any problems or concerns related to the events? |
Y=Yes, N=No, blank=missing |
OTHER |
Unique to DD2796
|
INJ_PROB_OTHER |
4 |
if yes, are you still having any problems or concerns related to the events, pl |
Text Field |
OTHER |
Unique to DD2796
|
DEPLOY_DANGER |
5a |
During your deployment: Did you ever feel like you were in great danger of being |
Y=Yes, N=No, blank=missing |
DEPLOYMENT |
Unique to DD2796
|
DEPLOY_KILLED |
5b |
During your deployment: Did you encounter dead bodies or see people killed or w |
Y=Yes, N=No, blank=missing |
DEPLOYMENT |
Unique to DD2796
|
DEPLOY_WEAPON |
5c |
During your deployment: Did you engage in direct combat where you discharged a w |
Y=Yes, N=No, blank=missing |
DEPLOYMENT |
Unique to DD2796
|
TIMES_SEEN |
6 |
Since you returned from deployment, how many times have you gone to a health car |
0=No visits, 1=1 visit, 2=2-3 visits, 3=4-5 visits |
OTHER |
Unique to DD2796
|
REC_CARE_MH |
7 |
During this deployment, did you receive care for combat stress or a mental healt |
Y=Yes, N=No, blank=missing |
OTHER |
Unique to DD2796
|
REC_CARE_MH_TEXT |
7 |
If yes, please explain |
Text Field |
OTHER |
Unique to DD2796
|
HOSPITALIZED |
8 |
During this deployment, did you have to spend one or more nights in a hospital a |
Y=Yes, N=No, blank=missing |
OTHER |
Unique to DD2796
|
HOSPITALIZED_TEXT |
8 |
If hospitalized during deployment, reasons/dates |
Text Field |
OTHER |
Unique to DD2796
|
DIFF_PHYSICAL |
9 |
During the PAST MONTH, how difficult have physical health problems (illness or i |
1=Not difficult at all, 2=Somewhat difficult, 3=Ve |
OTHER |
Unique to DD2796
|
EXP_BLAST |
10a1 |
During this deployment, did any of the following happen to you: Blast or explosi |
Y=Yes, N=No, blank=missing |
TBI_BLAST |
Semantic Match – DD2796 & ANAM
|
EXP_BLAST_LT25 |
10a1 |
If yes, please estimate your distance from the closest blast or explosion: Less |
Y=Yes, N=No, blank=missing |
TBI_BLAST |
Unique to DD2796
|
EXP_BLAST_25_50 |
10a1 |
If yes, please estimate your distance from the closest blast or explosion: Betwe |
Y=Yes, N=No, blank=missing |
TBI_BLAST |
Unique to DD2796
|
EXP_BLAST_50_100 |
10a1 |
If yes, please estimate your distance from the closest blast or explosion: Betwe |
Y=Yes, N=No, blank=missing |
TBI_BLAST |
Unique to DD2796
|
EXP_BLAST_GT100 |
10a1 |
If yes, please estimate your distance from the closest blast or explosion: Great |
Y=Yes, N=No, blank=missing |
TBI_BLAST |
Unique to DD2796
|
EXP_CRASH |
10a2 |
During this deployment, did any of the following happen to you: Vehicular accide |
Y=Yes, N=No, blank=missing |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
EXP_WOUND_HEAD |
10a3a |
During this deployment, did any of the following happen to you: fragment or bull |
Y=Yes, N=No, blank=missing |
TBI_BLAST |
Unique to DD2796
|
EXP_WOUND_OTHER |
10a3a |
During this deployment, did any of the following happen to you: fragment or bull |
Y=Yes, N=No, blank=missing |
TBI_BLAST |
Unique to DD2796
|
EXP_OTHER_INJ |
10a4 |
During this deployment, did any of the following happen to you: other injury (e. |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_TEXT |
10a |
If yes to any of the above, please explain |
Text Field |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
IMMED_LOC |
10b1 |
As a result of any of the events in 10.a, did you receive jolt or blow to your h |
Y=Yes, N=No, blank=missing |
TBI_BLAST |
Semantic Match – DD2796 & ANAM
|
IMMED_LOC_LENGTH |
10b1 |
If yes, for about how long were you knocked out |
1=Less than five minutes, 2=5-30 minutes, 3=30+ mi |
TBI_BLAST |
Unique to DD2796
|
IMMED_MEMORY |
10b2 |
Losing memory of events before or after the injury |
Y=Yes, N=No, blank=missing |
TBI_BLAST |
Semantic Match – DD2796 & ANAM
|
IMMED_DAZED |
10b3 |
Seeing stars, becoming disoriented, functioning
differently, or nearly blacking |
Y=Yes, N=No, blank=missing |
TBI_BLAST |
Semantic Match – DD2796 & ANAM
|
NUM_JOLT |
10c |
How many total times during this deployment did you receive a blow or jolt to yo |
0=0 1=1 2=2 3=3 4=more than 3 |
TBI_BLAST |
Semantic Match – DD2796 & ANAM
|
NUM_JOLT_TEXT |
10c |
If more than 3, list number of times |
Text Field |
TBI_BLAST |
Unique to DD2796
|
PAIN_STOMACH |
11a |
During the PAST MONTH, how much have you been bothered by: stomach pain |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
PAIN_BACK |
11b |
During the PAST MONTH, how much have you been bothered by: back pain |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
PAIN_ARMS_LEGS |
11c |
During the PAST MONTH, how much have you been bothered by: pain in the arms, leg |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
CRAMPS |
11d |
During the PAST MONTH, how much have you been bothered by: menstrual cramps or |
0=Not bothered at all, 1=Bothered a little, 2=both |
OTHER |
Unique to DD2796
|
HEADACHES |
11e |
During the PAST MONTH, how much have you been bothered by: headaches |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Semantic Match – DD2796 & ANAM
|
CHEST_PAIN |
11f |
During the PAST MONTH, how much have you been bothered by: chest pain |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
DIZZINESS |
11g |
During the PAST MONTH, how much have you been bothered by: dizziness |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
FAINTING |
11h |
During the PAST MONTH, how much have you been bothered by: fainting spells |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
HEART_RACE |
11i |
During the PAST MONTH, how much have you been bothered by: feeling your heart po |
0=Not bothered at all, 1=Bothered a little, 2=both |
OTHER |
Unique to DD2796
|
SHORTNESS_BREATH |
11j |
During the PAST MONTH, how much have you been bothered by: shortness of breath |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
PAIN_SEX |
11k |
During the PAST MONTH, how much have you been bothered by: pain or problems duri |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
DIARRHEA |
11l |
During the PAST MONTH, how much have you been bothered by: constipation, loose b |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
NAUSEA |
11m |
During the PAST MONTH, how much have you been bothered by: nausea, gas, or indig |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
LOW_ENERGY |
11n |
During the PAST MONTH, how much have you been bothered by: feeling tired or havi |
0=Not bothered at all, 1=Bothered a little, 2=both |
OTHER |
Unique to DD2796
|
TROUBLE_SLEEPING |
11o |
During the PAST MONTH, how much have you been bothered by: trouble sleeping |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Semantic Match – DD2796 & ANAM
|
TROUBLE_CONCENTRATING |
11p |
During the PAST MONTH, how much have you been bothered by: Trouble concentrating |
0=Not bothered at all, 1=Bothered a little, 2=both |
OTHER |
Semantic Match – DD2796 & ANAM
|
MEMORY_PROBLEMS |
11q |
During the PAST MONTH, how much have you been bothered by: memory problems |
0=Not bothered at all, 1=Bothered a little, 2=both |
OTHER |
Semantic Match – DD2796 & ANAM
|
BALANCE_PROBLEMS |
11r |
During the PAST MONTH, how much have you been bothered by: balance problems |
0=Not bothered at all, 1=Bothered a little, 2=both |
OTHER |
Unique to DD2796
|
HEARING_NOISES |
11s |
During the PAST MONTH, how much have you been bothered by: noises in your head |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
TROUBLE_HEARING |
11t |
During the PAST MONTH, how much have you been bothered by: trouble hearing |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
SENSITIVE_LIGHT |
11u |
During the PAST MONTH, how much have you been bothered by: sensitivity to bright |
0=Not bothered at all, 1=Bothered a little, 2=both |
MENTAL_HEALTH |
Unique to DD2796
|
IRRITABLE |
11v |
During the PAST MONTH, how much have you been bothered by: becoming easily anno |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
FEVER |
11w |
During the PAST MONTH, how much have you been bothered by: fever |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
COUGH |
11x |
During the PAST MONTH, how much have you been bothered by: cough lasting more th |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
NUMBNESS |
11y |
During the PAST MONTH, how much have you been bothered by: numbness or tingling |
0=Not bothered at all, 1=Bothered a little, 2=both |
MENTAL_HEALTH |
Unique to DD2796
|
HARD_MAKING_DECISIONS |
11z |
During the PAST MONTH, how much have you been bothered by: hard to make up your |
0=Not bothered at all, 1=Bothered a little, 2=both |
OTHER |
Unique to DD2796
|
RED_EYES |
11aa |
During the PAST MONTH, how much have you been bothered by: watery, red eyes |
0=Not bothered at all, 1=Bothered a little, 2=both |
OTHER |
Unique to DD2796
|
DIMMING_VISION |
11bb |
During the PAST MONTH, how much have you been bothered by: dimming of vision, li |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
SKIN_RASH |
11cc |
During the PAST MONTH, how much have you been bothered by: skin rash and/or les |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
PAIN_URINATION |
11dd |
During the PAST MONTH, how much have you been bothered by: pain with urination, |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
PAIN_TOOTH |
11ee |
During the PAST MONTH, how much have you been bothered by: bleeding gums, tooth |
0=Not bothered at all, 1=Bothered a little, 2=both |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
STRESSOR_NONE |
12a |
Over the PAST MONTH, which major life stressors, if any, have you experienced th |
1=Checked (None), 0=Not Checked |
STRESSORS |
Exact Match (all same field name)
|
STRESSOR_LEGAL |
12a |
Legal |
1=Checked, 0=Not Checked |
STRESSORS |
Exact Match (all same field name)
|
STRESSOR_MONEY |
12a |
Financial |
1=Checked, 0=Not Checked |
STRESSORS |
Exact Match (all same field name)
|
STRESSOR_SPIRIT |
12a |
Spiritual |
1=Checked, 0=Not Checked |
STRESSORS |
Exact Match (all same field name)
|
STRESSOR_SUB |
12a |
Substance abuse (including alcohol) |
1=Checked, 0=Not Checked |
STRESSORS |
Exact Match (all same field name)
|
STRESSOR_FAM |
12a |
Family/relationship |
1=Checked, 0=Not Checked |
STRESSORS |
Exact Match (all same field name)
|
STRESSOR_WORK |
12a |
Employment |
1=Checked, 0=Not Checked |
STRESSORS |
Exact Match (all same field name)
|
STRESSOR_SLEEP |
12a |
Sleep |
1=Checked, 0=Not Checked |
STRESSORS |
Exact Match (all same field name)
|
STRESSOR_MH |
12a |
Behavioral health |
1=Checked, 0=Not Checked |
STRESSORS |
Exact Match (all same field name)
|
STRESSOR_OTH |
12a |
Other |
1=Checked, 0=Not Checked |
STRESSORS |
Exact Match (all same field name)
|
STRESSORS_TEXT |
12a |
Please list and explain |
Text Field |
STRESSORS |
Exact Match (all same field name)
|
STRESSORS_HELP |
12b |
Are you currently in treatment or getting professional help for this concern? |
Y=Yes, N=No, blank=missing |
STRESSORS |
Exact Match (all same field name)
|
CARE_MENTAL |
13 |
In the PAST YEAR, did you receive care for any mental health condition or concer |
Y=Yes, N=No, blank=missing |
OTHER |
Exact Match (all same field name)
|
CARE_MENTAL_TEXT |
13 |
If yes, please explain |
Text Field |
OTHER |
Exact Match (all same field name)
|
CURRENT_MEDS |
14 |
What prescription or over-the-counter medications (including herbals/supplements |
0=None, 1=Yes response (Medications) |
OTHER |
Exact Match (all same field name)
|
CURRENT_MEDS_TEXT |
14 |
If yes, please list. |
Text Field |
OTHER |
Exact Match (all same field name)
|
ETOH_OFTEN |
15a |
How often do you have a drink containing alcohol |
0=Never 1=Monthly or Less 2=2-4 times a month 3=2- |
SUBSTANCE_USE |
Exact Match (all same field name)
|
ETOH_DAY |
15b |
How many drinks containing alcohol do you have on a typical day when you are dri |
1=1 or 2, 2=3 or 4, 3=5 or 6, 4=7 to 9 5=10 or mor |
SUBSTANCE_USE |
Exact Match (all same field name)
|
ETOH_BINGE |
15c |
How often do you have six or more drinks on one occasion |
0=Never 1=Less than monthly 2=Monthly 3=Weekly 4=D |
SUBSTANCE_USE |
Exact Match (all same field name)
|
NIGHTMARES |
16a |
Have you ever had any experience that was so frightening , horrible, or upsettin |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
AVOID_SITUATIONS |
16b |
Have you ever had any experience that was so frightening , horrible, or upsettin |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
ON_GUARD |
16c |
Have you ever had any experience that was so frightening , horrible, or upsettin |
Y=Yes, N=No, blank=missing |
OTHER |
Exact Match (all same field name)
|
DETACHED |
16d |
Have you ever had any experience that was so frightening , horrible, or upsettin |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
BLAME |
16e |
Felt guilt or unable to stop blaming yourself or others for the event(s) or any |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
MEMORIES |
16f |
Have you been bothered by that problem in the PAST MONTH. Repeated, disturbing m |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
DREAMS |
16g |
Have you been bothered by that problem in the PAST MONTH. Repeated, disturbing d |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
RELIVING |
16h |
Have you been bothered by that problem in the PAST MONTH. Suddenly acting or fee |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
UPSET |
16i |
Have you been bothered by that problem in the PAST MONTH. Feeling very upset whe |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
PHYS_REACTION |
16j |
Have you been bothered by that problem in the PAST MONTH. Having physical reacti |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
AVOID_THINK |
16k |
Have you been bothered by that problem in the PAST MONTH. Avoid thinking about o |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
AVOID_ACTIVITIES |
16l |
Have you been bothered by that problem in the PAST MONTH. Avoid activities or si |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
TROUBLE_MEMORY |
16m |
Have you been bothered by that problem in the PAST MONTH. Trouble remembering im |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
DISINTEREST |
16n |
Have you been bothered by that problem in the PAST MONTH. Loss of interest in th |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
DISTANT |
16o |
Have you been bothered by that problem in the PAST MONTH. Feeling distant or cut |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
NUMB |
16p |
Have you been bothered by that problem in the PAST MONTH. Feeling emotionally nu |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
DOOM |
16q |
Have you been bothered by that problem in the PAST MONTH. Feeling as if your fut |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
INSOMNIA |
16r |
Have you been bothered by that problem in the PAST MONTH. Trouble falling or sta |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
ANGRY_OUTBURSTS |
16s |
Have you been bothered by that problem in the PAST MONTH. Feeling irritable or h |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
CONCENTRATE |
16t |
Have you been bothered by that problem in the PAST MONTH. Having difficulty conc |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
WATCHFUL |
16u |
Have you been bothered by that problem in the PAST MONTH. Being “super alert” or |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
ALERT |
16v |
Have you been bothered by that problem in the PAST MONTH. Feeling jumpy or easil |
0=Not at all, 1=A little bit, 2=Moderately, 3=Quit |
MENTAL_HEALTH |
Exact Match (all same field name)
|
LIFE_DIFFICULT |
16w |
How difficult have these problems (16f. through 16v.) made it for you to do your |
0=Not difficult at all, 1=Somewhat difficult, 2=Ve |
MENTAL_HEALTH |
Exact Match (all same field name)
|
WEEKS_LITTLE_INTEREST |
17a |
Over the LAST 2 WEEKS, how often have you been bothered by the following problem |
0=Not at All 1=Few or several days 2=More than hal |
MENTAL_HEALTH |
Exact Match (all same field name)
|
WEEKS_DEPRESSED |
17b |
Over the LAST 2 WEEKS, how often have you been bothered by the following problem |
0=Not at All 1=Few or several days 2=More than hal |
MENTAL_HEALTH |
Exact Match (all same field name)
|
WEEKS_SLEEP |
17c |
Over the LAST 2 WEEKS, how often have you been bothered by the following problem |
0=Not at all, 1=Few or several days, 3=More than h |
MENTAL_HEALTH |
Exact Match (all same field name)
|
WEEKS_TIRED |
17d |
Over the LAST 2 WEEKS, how often have you been bothered by the following problem |
0=Not at all, 1=Few or several days, 3=More than h |
MENTAL_HEALTH |
Exact Match (all same field name)
|
WEEKS_APPETITE |
17e |
Over the LAST 2 WEEKS, how often have you been bothered by the following problem |
0=Not at all, 1=Few or several days, 3=More than h |
MENTAL_HEALTH |
Exact Match (all same field name)
|
WEEKS_FAILURE |
17f |
Over the LAST 2 WEEKS, how often have you been bothered by the following problem |
0=Not at all, 1=Few or several days, 3=More than h |
MENTAL_HEALTH |
Exact Match (all same field name)
|
WEEKS_CONCENTRATE |
17g |
Over the LAST 2 WEEKS, how often have you been bothered by the following problem |
0=Not at all, 1=Few or several days, 3=More than h |
MENTAL_HEALTH |
Exact Match (all same field name)
|
WEEKS_LETHARGIC_JUMPY |
17h |
Over the LAST 2 WEEKS, how often have you been bothered by the following problem |
0=Not at all, 1=Few or several days, 3=More than h |
MENTAL_HEALTH |
Exact Match (all same field name)
|
WEEKS_PROBLEMS |
17i |
How difficult have these problems (17a.through17h.) made it for you to do your w |
0=Not difficult at all, 1=Somewhat difficult, 2=Ve |
MENTAL_HEALTH |
Exact Match (all same field name)
|
WORRIED_EXPOSURE |
18 |
Are you worried about your health because you believe you were exposed to someth |
Y=Yes, N=No, blank=missing |
OTHER |
Unique to DD2796
|
EXPOSURE_TEXT |
18 |
If yes, please explain |
Text Field |
OTHER |
Unique to DD2796
|
OPEN_BURN_PIT |
19a |
During this deployment were you based or stationed at a location where an open b |
Y=Yes, N=No, U=Not Sure |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
AIRBORNE_CHEM |
19b |
During this deployment were you exposed to toxic airborne chemicals or other air |
Y=Yes, N=No, U=Not Sure |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
ENROLLED_BURN_PIT |
19c |
Are you enrolled in the Airborne Hazards and Open Burn Pit Registry? |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
REGISTER_BURN_PIT |
19d |
if you are eligible , do you elect to enroll in the Airborne Hazards Open Burn |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_CHEM |
20 |
Do you think you were exposed to any chemical, biological, or radiological warfa |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_CHEM_TEXT |
20 |
If yes, please explain |
Text Field |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_DU |
21 |
Were you in a vehicle hit by a depleted uranium (DU) round; inside a destroyed v |
Y=Yes, N=No, U=Don't know |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_DU_TEXT |
21 |
If yes, please explain |
Text Field |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
MEDS_MALARIA |
22 |
Were you told to take medicines to prevent malaria |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
CHLOROQUINE |
22 |
Anti-malarial medications received: Chloroquine |
0=Blank, 1=Yes |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
MEDS_CHLORO |
22 |
Took all pills: Chloroquine (Aralen®) |
Y=Yes, C=Yes (currently taking), N=No |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
DOXYCYLINE |
22 |
Anti-malarial medications received: Doxycycline |
0=Blank, 1=Yes |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
MEDS_DOXY |
22 |
Took all pills: Doxycycline (Vibramycin®) |
Y=Yes, C=Yes (currently taking), N=No |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
MALARONE |
22 |
Anti-malarial medications received: MALARONE |
0=Blank, 1=Yes |
OTHER |
Unique to DD2796
|
MEDS_MAL |
22 |
Took all pills: Malarone® |
Y=Yes, C=Yes (currently taking), N=No |
OTHER |
Unique to DD2796
|
MEFLOQUINE |
22 |
Anti-malarial medications received: MEFLOQUINE |
0=Blank, 1=Yes |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
MEDS_MEF |
22 |
Took all pills: Mefloquine (Lariam®) |
Y=Yes, C=Yes (currently taking), N=No |
OTHER |
Unique to DD2796
|
PRIMAQUINE |
22 |
Anti-malarial medications received: PRIMAQUINE |
0=Blank, 1=Yes |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
MEDS_PRIM |
22 |
Took all pills: Primaquine |
Y=Yes, C=Yes (currently taking), N=No |
OTHER |
Unique to DD2796
|
TAFENOQUINE |
22 |
Anti-malarial medications received: TAFENOQUINE |
0=Blank, 1=Yes |
OTHER |
Unique to DD2796
|
OTHER_MALARIA |
22 |
Anti-malarial medications received: OTHER |
0=Blank, 1=Yes |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
MEDS_TAF |
22 |
Took all pills: Tafenoquine |
Y=Yes, C=Yes (currently taking), N=No |
OTHER |
Unique to DD2796
|
MEDS_OTHER |
22 |
Took all Pills: Other |
Y=Yes, C=Yes (currently taking), N=No |
OTHER |
Unique to DD2796
|
MEDS_OTHER_TEXT |
22 |
Other malaria medication name |
Text Field |
OTHER |
Unique to DD2796
|
UNK_MALARIA |
22 |
Anti-malarial medications received: Given pills but do not know drug name |
0=Blank, 1=Yes |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
MEDS_UNK |
22 |
Took all pills: given pills but do not know drug name |
Y=Yes, N=No, blank=missing |
OTHER |
Unique to DD2796
|
BITTEN |
23 |
Were you bitten or scratched by an animal during your deployment |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
BITTEN_TEXT |
23 |
If yes, please explain what kind of animal was involved, your injury, and what h |
Text Field |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
REQ_PROVIDER |
24 |
Would you like to schedule an appointment with a health care provider to discuss |
Y=Yes, N=No, blank=missing |
REFERRAL_ACTION |
Unique to DD2796
|
REQ_STRESS |
25 |
Are you interested in receiving information or assistance for a stress, emotiona |
Y=Yes, N=No, blank=missing |
REFERRAL_ACTION |
Unique to DD2796
|
REQ_FAMILY |
26 |
Are you interested in receiving assistance for a family or relationship concern? |
Y=Yes, N=No, blank=missing |
REFERRAL_ACTION |
Unique to DD2796
|
REQ_CHAPLAIN |
27 |
Would you like to schedule a visit with a chaplain or a community support counse |
Y=Yes, N=No, blank=missing |
REFERRAL_ACTION |
Unique to DD2796
|
HCP_LNAME |
HCP1 |
HCP provider's Last Name |
Text Field |
PROVIDER |
Exact Match (all same field name)
|
HCP_FNAME |
HCP2 |
HCP provider's First Name |
Text Field |
PROVIDER |
Exact Match (all same field name)
|
HCP_MNAME |
HCP3 |
HCP provider's Middle Name |
Text Field |
PROVIDER |
Exact Match (all same field name)
|
HCP_SERVICE |
HCP4 |
HCP provider's Service Branch |
F=Air Force, A=Army, N=Navy, M=Marine Corps, S=Spa |
DEPLOYMENT |
Exact Match (all same field name)
|
HCP_STATUS |
HCP5 |
HCP provider's Status |
A=AD, G=Guard, R=Reservist, AGR=AGR, CIV=Civ, CTR= |
PROVIDER |
Exact Match (all same field name)
|
HCP_STATUS_TEXT |
HCP5 |
HCP provider's Status Text |
Text Field |
PROVIDER |
Exact Match (all same field name)
|
HCP_TITLE |
HCP6 |
HCP provider's Title |
PHY=MD/DO, NP=NP, PA=PA, APN=APN, IDC=IDC, IDHST=I |
PROVIDER |
Exact Match (all same field name)
|
HCP_EMAIL |
HCP7 |
HCP provider's Email |
Text Field |
PROVIDER |
Exact Match (all same field name)
|
HCP_FACILITY |
HCP8 |
Facility Name |
Text Field |
PROVIDER |
Exact Match (all same field name)
|
HCP_UNIT |
HCP9 |
Unit Name |
Text Field |
PROVIDER |
Exact Match (all same field name)
|
HCP_ADDR |
HCP10 |
HCP provider's Address and City |
Text Field |
PROVIDER |
Exact Match (all same field name)
|
HCP_STATE |
HCP11 |
HCP provider's STATE |
Text Field |
PROVIDER |
Exact Match (all same field name)
|
HCP_ZIP |
HCP12 |
HCP provider's ZIP Code |
Text Field |
PROVIDER |
Exact Match (all same field name)
|
HCP_PHONE |
HCP13 |
HCP provider's Phone number |
Text Field |
PROVIDER |
Exact Match (all same field name)
|
HP_D_ARRIVAL |
META |
Deployer reports arriving in theater on |
YYYYMMDD |
DEPLOYMENT |
Unique to DD2796
|
HP_D_DEPART |
META |
Deployer reports departing theater on |
YYYYMMDD |
DEPLOYMENT |
Unique to DD2796
|
SELF_HEALTH_FOLLOWUP |
HP1a |
Self health Rating |
0=Not answered, 1=Deployer Indicated Concern |
OTHER |
Exact Match (all same field name)
|
HP_SELF_DEPLOY_TEXT |
HP1a |
Self Health Rating Deployer Response |
Text Field |
DEPLOYMENT |
Unique to DD2796
|
HP_SELF_PROVIDER_TEXT |
HP1a |
Self Health Rating Provider Comments |
Text Field |
OTHER |
Unique to DD2796
|
HP_HEALTH_CHANGE |
HP1b |
Change in health post-deployment |
0=Not answered, 1=Deployer Indicated Concern |
OTHER |
Unique to DD2796
|
HP_DEP_HEALTH_CHANGE_TEXT |
HP1b |
Change in health post-deployment Deployer's Response |
Text Field |
OTHER |
Unique to DD2796
|
HP_HEALTH_CHANGE_TEXT |
HP1b |
Change in health post-deployment Provider comments |
Text Field |
OTHER |
Unique to DD2796
|
HP_INURY_CONCERN |
HP2a |
Did deployer mark that he/she is still having a problem or concern related to a |
Y=Yes, N=No, X=Not answered by deployer, blank=mis |
OTHER |
Unique to DD2796
|
HP_INURY_CONCERN_REF |
HP2b |
Refer for evaluation? |
Y=Yes, N=No, blank=missing |
OTHER |
Unique to DD2796
|
HP_INJURY_NO_REF |
HP2b |
Refer for evaluation? If no to 2b. |
1=Already under care, 2=Already has referral, 3=no |
OTHER |
Unique to DD2796
|
HP_INJURY_NO_REF_TEXT |
HP2b |
Refer for evaluation, if no to 2b, Other Reason explain |
Text Field |
REFERRAL_ACTION |
Unique to DD2796
|
HP_DEPLOY_DANGER |
HP3 |
Deployment experiences : Danger of being killed |
0=Not answered, 1=Yes response |
DEPLOYMENT |
Unique to DD2796
|
HP_DEPLOY_DANGER_TEXT |
HP3 |
Deployment experiences : Danger of being killed (Provider comments) |
Text Field |
DEPLOYMENT |
Unique to DD2796
|
HP_DEPLOY_BODIES |
HP3 |
Deployment experiences : Encountered bodies or saw people killed or wounded |
0=Not answered, 1=Yes response |
DEPLOYMENT |
Unique to DD2796
|
HP_DEPLOY_BODIES_TEXT |
HP3 |
Deployment experiences : Encountered bodies or saw people killed or wounded: ( |
Text Field |
DEPLOYMENT |
Unique to DD2796
|
HP_DEPLOY_WEAPON |
HP3 |
Deployment experiences : In direct combat and discharged weapon |
0=Not answered, 1=Yes response |
DEPLOYMENT |
Unique to DD2796
|
HP_DEPLOY_WEAPON_TEXT |
HP3 |
Deployment experiences : In direct combat and discharged weapon: (Provider Com |
Text Field |
DEPLOYMENT |
Unique to DD2796
|
HP_VISITS |
HP4 |
Address concerns identified on deployer question: Health care visits since retu |
0=Not answered, 1=Yes response |
OTHER |
Unique to DD2796
|
HP_VISITS_DEPLOYER_TEXT |
HP4 |
Address concerns identified on deployer question: Health care visits since retu |
Text Field |
DEPLOYMENT |
Unique to DD2796
|
HP_VISITS_TEXT |
HP4 |
Address concerns identified on deployer question: Health care visits since retu |
Text Field |
OTHER |
Unique to DD2796
|
HP_COMBAT |
HP4 |
Address concerns identified on deployer question: Health care combat since retu |
0=Not answered, 1=Yes response |
OTHER |
Unique to DD2796
|
HP_COMBAT_DEPLOYER_TEXT |
HP4 |
Address concerns identified on deployer question: Health care combat since retu |
Text Field |
DEPLOYMENT |
Unique to DD2796
|
HP_COMBAT_TEXT |
HP4 |
Address concerns identified on deployer question: Health care combat since retu |
Text Field |
OTHER |
Unique to DD2796
|
HP_HOSPITALIZED |
HP4 |
Address concerns identified on deployer question: Hospitalized since return |
0=Not answered, 1=Yes response |
OTHER |
Unique to DD2796
|
HP_HOSPITALIZED_DEPLOYER_TEXT |
HP4 |
Address concerns identified on deployer question: Hospitalized since return (De |
Text Field |
DEPLOYMENT |
Unique to DD2796
|
HP_HOSPITALIZED_TEXT |
HP4 |
Address concerns identified on deployer question: Hospitalized since return (Pr |
Text Field |
OTHER |
Unique to DD2796
|
HP_LIMITATIONS |
HP4 |
Address concerns identified on deployer question: Physical Limitations/problems |
0=Not answered, 1=Yes response |
OTHER |
Unique to DD2796
|
HP_LIMITATIONS_DEPLOYER_TEXT |
HP4 |
Address concerns identified on deployer question: Physical Limitations/problems |
Text Field |
DEPLOYMENT |
Unique to DD2796
|
HP_LIMITATIONS_TEXT |
HP4 |
Address concerns identified on deployer question: Physical Limitations/problems( |
Text Field |
OTHER |
Unique to DD2796
|
HP_INJURY |
HP5a |
Did deployer have an injury based on their responses to question 10.a.? |
Y=Yes, N=No, blank=missing |
OTHER |
Unique to DD2796
|
HP_CONCUSSION |
HP5b |
Did deployer have a possible concussion based on their responses to questions 10 |
Y=Yes, N=No, blank=missing |
TBI_BLAST |
Unique to DD2796
|
HP_CONCUSSION_REF |
HP5c |
Did the deployer have a possible concussion based on their responses to question |
Y=Yes, N=No, blank=missing |
TBI_BLAST |
Unique to DD2796
|
HP_CONCUSSION_NOREF |
HP5c |
Evaluate injury history and concussion-related experiences and symptoms: Refer f |
1=Already under care, 2=Already has referral, 3=no |
TBI_BLAST |
Unique to DD2796
|
HP_CONCUSSION_NOREF_TEXT |
HP5c |
Refer for evaluation, Other Reason explain |
Text Field |
TBI_BLAST |
Unique to DD2796
|
HP_BOTHERED_LOT |
HP6 |
List of symptoms reported as “Bothered a Lot” on Deployer Questions 11a. through |
Text Field |
OTHER |
Unique to DD2796
|
HP_BOTHERED_LITTLE |
HP6 |
List of symptoms reported as “Bothered a Little” on Deployer Questions 11a. thro |
Text Field |
OTHER |
Unique to DD2796
|
HP_PHQ_15 |
HP6 |
Physical symptom (PHQ-15) severity score for Deployer Questions 11a. through 11o |
1=Minimal <4 (0-4) , 2=Low 5-9, 3=Medium 10-14, 4= |
MENTAL_HEALTH |
Unique to DD2796
|
HP_POST_DEP_SYMPTOMS |
HP6a |
Does deployer have evidence of high generalized post-deployment physical symptom |
Y=Yes, N=No, X=Not answered by deployer, blank=mis |
OTHER |
Unique to DD2796
|
HP_POST_DEP_REF |
HP6b |
Based on deployer's responses to deployer questions 1a. Through 11ee. Is a refer |
Y=Yes, N=No, blank=missing |
OTHER |
Unique to DD2796
|
HP_POST_DEP_NOREF |
HP6b |
Is a referral indicated? If no, other reason |
1=Already under care, 2=Already has referral, 3=no |
OTHER |
Unique to DD2796
|
HP_POST_DEP_TEXT |
HP6b |
Based on deployer's responses to deployer questions 11a. Through 11ee. Is a refe |
Text Field |
OTHER |
Unique to DD2796
|
HP_STRESSOR |
HP7 |
Major life stressor as reported on deployer question 12: Did deployer mark they |
Y=Yes, N=No, X=Not answered by deployer, blank=mis |
STRESSORS |
Unique to DD2796
|
HP_STRESSOR_TEXT |
HP7 |
If yes, ask additional questions to determine level of problem |
Text Field |
STRESSORS |
Unique to DD2796
|
HP_DEPLOYER_STRESS_TEXT |
HP7 |
Major life stressor as reported on deployer question 9: Did deployer mark they h |
Text Field |
DEPLOYMENT |
Unique to DD2796
|
HP_STRESSOR_REF |
HP7 |
Consider need for referral. Referral indicated? |
Y=Yes, N=No, blank=missing |
STRESSORS |
Unique to DD2796
|
HP_STRESSOR_NOREF |
HP7 |
Consider need for referral. Referral indicated? If no |
1=Already under care, 2=Already has referral, 3=no |
STRESSORS |
Unique to DD2796
|
HP_STRESSOR_NOREF_TEXT |
HP7 |
Consider need for referral. Referral indicated? If no, other reason, explain |
Text Field |
STRESSORS |
Unique to DD2796
|
HP_MENTAL_HEALTH |
HP8 |
Self-reported history of prescription or over-the-counter medications as describ |
0=Not answered, 1=Yes response |
OTHER |
Unique to DD2796
|
HP_MENTAL_HEALTH_DEP_TEXT |
HP8 |
Self-reported history of prescription or over-the-counter medications as describ |
Text Field |
OTHER |
Unique to DD2796
|
HP_MENTAL_HEALTH_TEXT |
HP8 |
Self-reported history of prescription or over-the-counter medications as describ |
Text Field |
OTHER |
Unique to DD2796
|
HP_OTC_MEDS |
HP8 |
Self-reported history of prescription or over-the-counter medications as describ |
0=Not answered, 1=Yes response |
OTHER |
Unique to DD2796
|
HP_OTC_MEDS_DEP_TEXT |
HP8 |
Self-reported history of prescription or over-the-counter medications as describ |
Text Field |
OTHER |
Unique to DD2796
|
HP_OTC_MEDS_TEXT |
HP8 |
Self-reported history of prescription or over-the-counter medications as describ |
Text Field |
OTHER |
Unique to DD2796
|
AUDITC_SCREEN |
HP9 |
Deployer's AUDIT-C screening score |
0-12, N=Not answered by deployer, blank=missing |
SUBSTANCE_USE |
Exact Match (all same field name)
|
ETOH_WEEK_PROVIDER |
HP9 |
Number of drinks per week |
0-99 |
SUBSTANCE_USE |
Exact Match (all same field name)
|
ETOH_TOTAL_PROVIDER |
HP9 |
Number of drinks per occasion |
0-99 |
SUBSTANCE_USE |
Exact Match (all same field name)
|
REF_ETOH |
HP9 |
Referral indicated for evaluation ETOH |
Y=Yes, N=No, blank=missing |
SUBSTANCE_USE |
Exact Match (all same field name)
|
REF_ETOH_NEG |
HP9 |
Reason for no referral (state if AUDIT-C score was 8+) |
1=Already under care, 2=Already has referral, 3=no |
SUBSTANCE_USE |
Exact Match (all same field name)
|
REF_ETOH_TEXT |
HP9 |
Other reason for referral |
Text Field |
SUBSTANCE_USE |
Exact Match (all same field name)
|
PTSD_REPORTED |
HP10a |
Did deployer mark yes on three or more of questions 16a. through 16e? |
Y=Yes, N=No, X=Not answered by deployer, blank=mis |
MENTAL_HEALTH |
Exact Match (all same field name)
|
PCLC_SCORE |
HP10b |
If yes, deployer’s responses to questions 16f. through 16v. resulted in a PCL-C |
0-99, X=Not answered or incomplete |
MENTAL_HEALTH |
Semantic Match – All 3 Schemas
|
PCLC_INCOMPLETE |
HP10b |
16f. through 16w. were not answered or are incomplete |
1=Checked, 0=Not Checked |
MENTAL_HEALTH |
Exact Match (all same field name)
|
PCLC_MATRIX |
HP10b |
PTSD Intervention Matrix, Self-Reported Level of Functioning |
1 - Not difficult at all or somewhat difficult; 2= |
MENTAL_HEALTH |
Semantic Match – All 3 Schemas
|
REF_PTSD |
HP10 |
Referral indicated for PTSD |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
REF_PTSD_NEG |
HP10 |
Reason for no referral |
1=Already under care, 2=Already has referral, 3=no |
MENTAL_HEALTH |
Exact Match (all same field name)
|
REF_PTSD_TEXT |
HP10 |
Other reason for referral |
Text Field |
MENTAL_HEALTH |
Exact Match (all same field name)
|
DEPRESSION_REPORTED |
HP11a |
Did deployer mark “More than half the days” or “Nearly every day” on question 17 |
Y=Yes, N=No, X=Not answered by deployer, blank=mis |
MENTAL_HEALTH |
Exact Match (all same field name)
|
PHQ8_SCORE |
HP11b |
If yes, deployer’s responses to questions 17a. through 17h. resulted in a total |
0-99, X=not answered or incomplete, blank=missing |
MENTAL_HEALTH |
Semantic Match – All 3 Schemas
|
PHQ8_INCOMPLETE |
HP11b |
17c. through 17i. were not answered or incomplete. |
1=Checked, 0=Not Checked |
MENTAL_HEALTH |
Exact Match (all same field name)
|
PHQ8_MATRIX |
HP11b |
Depression Intervention Matrix, Self-Reported Level of Functioning |
1 - Not difficult at all or somewhat difficult; 2= |
MENTAL_HEALTH |
Exact Match (all same field name)
|
REF_DEPRESSION |
HP11c |
Referral indicated for Depression |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
REF_DEPRESSION_NEG |
HP11c |
Reason for no referral |
1=Already under care, 2=Already has referral, 3=no |
MENTAL_HEALTH |
Exact Match (all same field name)
|
REF_DEPRESSION_TEXT |
HP11c |
Other reason for referral |
Text Field |
MENTAL_HEALTH |
Exact Match (all same field name)
|
EXPOSURE_CONCERNS |
HP12 |
Did deployer indicate a worry or possible exposure? |
Y=Yes, N=No, blank=missing |
OTHER |
Unique to DD2796
|
EXP_ANIMAL_BITES |
HP12 |
Deployer's exposure concern: Animal Bites |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_ANIMAL_BODIES |
HP12 |
Deployer's exposure concern: Animal Bodies (dead) |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_CHLORINE |
HP12 |
Deployer's exposure concern: Chlorine Gas |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_URANIUM |
HP12 |
Deployer's exposure concern: Depleted Uranium |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_VIBRATION |
HP12 |
Deployer's exposure concern: Excessive Vibration |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_FOG_OILS |
HP12 |
Deployer's exposure concern: Fog oils (smoke screen) |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_GARBAGE |
HP12 |
Deployer's exposure concern: Garbage |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_HUMAN_BODIES |
HP12 |
Deployer's exposure concern: Human Blood, body fluids, body parts, or dead bodi |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_POLLUTION |
HP12 |
Deployer's exposure concern: Industrial pollution |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_INSECT_BITES |
HP12 |
Deployer's exposure concern: Insect bites |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_RADIATION |
HP12 |
Deployer's exposure concern: Ionizing radiation |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_FUELS |
HP12 |
Deployer's exposure concern: JP8 or other fuels |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_LASER |
HP12 |
Deployer's exposure concern: Lasers |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_NOISE |
HP12 |
Deployer's exposure concern: Loud noises |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_PAINTS |
HP12 |
Deployer's exposure concern: Paints |
Y=Yes, N=No, blank=missing |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
EXP_PEST_ENVIRO |
HP12 |
Deployer's exposure concern: Pesticides |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_MICROWAVE |
HP12 |
Deployer's exposure concern: Radar/Microwaves |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_SAND |
HP12 |
Deployer's exposure concern: Sand/Dust |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_SMOKE_TRASH |
HP12 |
Deployer's exposure concern: Smoke from burning trash or feces |
Y=Yes, N=No, blank=missing |
PHYSICAL_SYMPTOMS |
Unique to DD2796
|
EXP_SMOKE_OIL |
HP12 |
Deployer's exposure concern: Smoke from oil fire |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_SOLVENTS |
HP12 |
Deployer's exposure concern: Solvents |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_SMOKE_HEATER |
HP12 |
Deployer's exposure concern: Tent Heater Smoke |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_FUMES_EXHAUST |
HP12 |
Deployer's exposure concern: Vehicle or truck exhaust fumes |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_WARFARE_AGENT |
HP12 |
Deployer's exposure concern: Chemical, biological, radiological warfare agent |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_OTHER |
HP12 |
Deployer's exposure concern: Other exposures to toxic chemicals or materials, s |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
EXP_OTHER_TEXT |
HP12 |
Deployer's exposure concern: Other exposures, please list |
Text Field |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
HP_EXP_REF |
HP12b |
Referral indicated |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
HP_EXP_NOREF |
HP12b |
Reason for no referral |
1=Already under care, 2=Already has referral, 3=no |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
HP_EXP_NOREF_TEXT |
HP12b |
Other reason for referral |
Text Field |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
HP_DU |
HP13 |
Did deployer mark "Yes" or "don't know" on questions 21? |
Y=Yes, N=No, blank=missing |
OTHER |
Unique to DD2796
|
HP_DU_REF |
HP13 |
Referral indicated for uranium exposure |
Y=Yes, N=No, blank=missing |
OTHER |
Unique to DD2796
|
HP_DU_NOREF |
HP13 |
Reason for no referral |
1=Already under care, 2=Already has referral, 3=no |
OTHER |
Unique to DD2796
|
HP_DU_NOREF_TEXT |
HP13 |
Other reason for referral |
Text Field |
REFERRAL_ACTION |
Unique to DD2796
|
HP_MALARIA_DEPLOYMENT |
HP14 |
Deployer reports having deployed to |
Text Field |
DEPLOYMENT |
Unique to DD2796
|
HP_MALARIA |
HP14 |
Deployment location required malaria prophylaxis |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
HP_MALARIA_COMPLY |
HP14 |
Did deployer receive anti-malarial prophylaxis AND report compliance? |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
HP_MALARIA_PRESCRIPTION |
HP14 |
If no, determine need for prophylaxis. Prescription indicated? |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
HP_MALARIA_NO_TEXT |
HP14 |
If no, briefly state reason |
Text Field |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
HP_BITTEN |
HP15 |
Did deployer mark "yes" on animal bite/scratch? |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
HP_BITTEN_REF |
HP15 |
If yes, based on details of event and care received is a referral and/or follow- |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
HP_BITTEN_NOREF |
HP15 |
If yes, based on details of event and care received is a referral and/or follow- |
1=was appropriately treated, 2=already under care, |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
HP_BITTEN_NOREF_TEXT |
HP15 |
If yes, based on details of event and care received is a referral and/or follow- |
Text Field |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
SUICIDE_A |
HP16a |
Over the PAST MONTH, have you wished you were dead or wished you could go to sle |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
SUICIDE_B |
HP16b |
Have you actually had any thoughts of killing yourself? |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
SUICIDE_C |
HP16c |
Over the PAST MONTH, have you been thinking about how you might do this? |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
SUICIDE_D |
HP16d |
Over the PAST MONTH, have you had these thoughts and had some intention of actin |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
SUICIDE_E1 |
HP16e1 |
Over the PAST MONTH, have you started to work out or worked out the details of h |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
SUICIDE_E2 |
HP16e2 |
At any time in the PAST MONTH, did you intend to carry out this plan? |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
SUICIDE_F1 |
HP16f1 |
In your lifetime, have you ever done anything, started to do anything, or prepar |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
SUICIDE_F2 |
HP16f2 |
Was this within the past three months? |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
SUICIDE_G_TEXT |
HP16g |
Conduct further risk assessment |
Text Field |
MENTAL_HEALTH |
Exact Match (all same field name)
|
SUICIDE_RISK |
HP16h |
Does deployer pose a current risk for harm to self? |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
VIOLENCE |
HP17a |
Ask, “Over the past month have you had thoughts or concerns that you might hurt |
Y=Yes, N=No, blank=missing |
OTHER |
Exact Match (all same field name)
|
VIOLENCE_TEXT |
HP17a |
If yes, ask additional questions to determine extent of problem (target, plan, i |
Text Field |
OTHER |
Exact Match (all same field name)
|
VIOLENCE_RISK |
HP17b |
Does member pose a current risk to others? |
Y=Yes, N=No, blank=missing |
OTHER |
Exact Match (all same field name)
|
VIOLENCE_RISK_TEXT |
HP17b |
Does member pose a current risk to others? If no, briefly state reason |
Text Field |
OTHER |
Exact Match (all same field name)
|
DEP_DEC_FORM |
HP18 |
deployer declined to complete form |
1=Checked, 0=Not Checked |
OTHER |
Exact Match (all same field name)
|
DEP_DEC_ASSESS |
HP18 |
deployer declined to complete interview |
1=Checked, 0=Not Checked |
OTHER |
Exact Match (all same field name)
|
REFER_NONE |
HP19a |
Summary of Providers identified concerns needing referral: None identified |
1=Checked, 0=Not Checked |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFER_PH |
HP19b |
Summary of Providers identified concerns needing referral: Physical Health |
Y=Yes, N=No, blank=missing |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFER_DENTAL |
HP19c |
Summary of Providers identified concerns needing referral: Dental Health |
Y=Yes, N=No, blank=missing |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFER_CONCUSSION |
HP19d |
Summary of Providers identified concerns needing referral: Concussion |
Y=Yes, N=No, blank=missing |
TBI_BLAST |
Unique to DD2796
|
REFER_MH |
HP19e |
Summary of Providers identified concerns needing referral: Mental health sympto |
Y=Yes, N=No, blank=missing |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFER_ETOH |
HP19f |
Summary of Providers identified concerns needing referral: alcohol use |
Y=Yes, N=No, blank=missing |
SUBSTANCE_USE |
Exact Match (all same field name)
|
REFER_PTSD |
HP19g |
Summary of Providers identified concerns needing referral: PTSD symptoms |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
REFER_DEPRESSION |
HP19h |
Summary of Providers identified concerns needing referral: Depression Symptoms |
Y=Yes, N=No, blank=missing |
MENTAL_HEALTH |
Exact Match (all same field name)
|
REFER_ENVIRO |
HP19i |
Summary of Providers identified concerns needing referral: Environment/work exp |
Y=Yes, N=No, blank=missing |
REFERRAL_ACTION |
Unique to DD2796
|
REFER_URANIUM |
HP19j |
Summary of Providers identified concerns needing referral: Depleted Uranium |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
REFER_MALARIA |
HP19k |
Summary of Providers identified concerns needing referral: Malaria Prophylaxis |
Y=Yes, N=No, blank=missing |
EXPOSURE_ENVIRONMENT |
Unique to DD2796
|
REFER_HARM |
HP19l |
Summary of Providers identified concerns needing referral: Risk of Self-harm |
Y=Yes, N=No, blank=missing |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFER_VIOLENCE |
HP19m |
Summary of Providers identified concerns needing referral: Risk of violence |
Y=Yes, N=No, blank=missing |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFER_OTHER |
HP19n |
Summary of Providers identified concerns needing referral: Other, list |
Y=Yes, N=No, blank=missing |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFER_OTHER_TEXT |
HP19n |
Summary of Providers identified concerns needing referral: Other, list |
Text Field |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_PRIMARY |
HP20a |
Referral indicated - Primary Care, Family Practice, Internal Medicine |
0=Within 24 hours, 1=Within 7 days, 2=Within 30 da |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_MENTAL_PRIMARY |
HP20b |
Referral indicated - Behavioral Health in Primary Care |
0=Within 24 hours, 1=Within 7 days, 2=Within 30 da |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_MENTAL_SPECIAL |
HP20c |
Referral indicated - Mental Health |
0=Within 24 hours, 1=Within 7 days, 2=Within 30 da |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_DENTAL |
HP20d |
Referral indicated - Dental |
0=Within 24 hours, 1=Within 7 days, 2=Within 30 da |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_OTHER_SPEC |
HP20e |
Referral indicated - Other specialty care |
0=Within 24 hours, 1=Within 7 days, 2=Within 30 da |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_AUDIOLOGY |
HP20e |
Referral indicated - Audiology |
0=Within 24 hours, 1=Within 7 days, 2=Within 30 da |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_DERM |
HP20e |
Referral indicated - dermatologic |
0=Within 24 hours, 1=Within 7 days, 2=Within 30 da |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_GYN |
HP20e |
Referral indicated - OB/GYN |
0=Within 24 hours, 1=Within 7 days, 2=Within 30 da |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_PT |
HP20e |
Referral indicated - PT |
0=Within 24 hours, 1=Within 7 days, 2=Within 30 da |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_TBI |
HP20e |
Referral indicated -TBI/Rehab Med |
0=Within 24 hours, 1=Within 7 days, 2=Within 30 da |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_PODIATRY |
HP20e |
Referral indicated - Podiatry |
0=Within 24 hours, 1=Within 7 days, 2=Within 30 da |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_SPEC_OTHER |
HP20e |
Referral to other specialty care listed |
0=Within 24 hours, 1=Within 7 days, 2=Within 30 da |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_SPEC_OTH_TEXT |
HP20e |
List of other specialty referral |
Text Field |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_CARE |
HP20f |
Referral to Case manager |
0=Within 24 hours, 1=Within 7 days, 2=Within 30 da |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_ABUSE |
HP20g |
Referral to Substance abuse program |
0=Within 24 hours, 1=Within 7 days, 2=Within 30 da |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_OTHER |
HP20j |
Other referral listed |
0=Within 24 hours, 1=Within 7 days, 2=Within 30 da |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_OTHER_TEXT |
HP20j |
List of other specialty referral |
Text Field |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REFTIME_COMMENTS |
HP21 |
Referral comments |
Text Field |
REFERRAL_ACTION |
Exact Match (all same field name)
|
REQ_HP_MED_APPT |
HP22 |
Request Medical Appointment |
0=Not answered, 1=Yes response |
REFERRAL_ACTION |
Unique to DD2796
|
REQ_HP_MED_APPT_TEXT |
HP22 |
Request Medical Appointment (Comments) |
Text Field |
REFERRAL_ACTION |
Unique to DD2796
|
REQ_HP_STRESS |
HP22 |
Request info on stress/emotional/alcohol |
0=Not answered, 1=Yes response |
REFERRAL_ACTION |
Unique to DD2796
|
REQ_HP_STRESS_TEXT |
HP22 |
Request info on stress/emotional/alcohol (Comments) |
Text Field |
REFERRAL_ACTION |
Unique to DD2796
|
REQ_HP_FAMILY |
HP22 |
Family/Relationship concern assistance |
0=Not answered, 1=Yes response |
REFERRAL_ACTION |
Unique to DD2796
|
REQ_HP_FAMILY_TEXT |
HP22 |
Family/Relationship concern assistance (Comments) |
Text Field |
REFERRAL_ACTION |
Unique to DD2796
|
REQ_HP_CHAPLAIN |
HP22 |
Chaplain/counselor visit request |
0=Not answered, 1=Yes response |
REFERRAL_ACTION |
Unique to DD2796
|
REQ_HP_CHAPLAIN_TEXT |
HP22 |
Chaplain/counselor visit request (Comments) |
Text Field |
REFERRAL_ACTION |
Unique to DD2796
|
APPOINTMENT_ASSIST |
HP23 |
Appointment Assistance |
Y=Checked, N=Not checked |
ADMIN |
Exact Match (all same field name)
|
APPOINTMENT_ASSIST_TEXT |
HP23 |
Appointment Assistance (Comments) |
Text Field |
ADMIN |
Unique to DD2796
|
BLOOD_SPECIMEN_REQ |
HP23 |
Information on post-deployment blood specimen requirement |
Y=Checked, N=Not checked |
OTHER |
Unique to DD2796
|
CONTRACT_SUP |
HP23 |
Contract support |
Y=Checked, N=Not checked |
ADMIN |
Exact Match (all same field name)
|
CONTRACT_SUP_TEXT |
HP23 |
Contract support text |
Text Field |
ADMIN |
Exact Match (all same field name)
|
COMMUNITY |
HP23 |
Community Service |
Y=Checked, N=Not checked |
ADMIN |
Exact Match (all same field name)
|
COMMUNITY_TEXT |
HP23 |
Community Service text |
Text Field |
ADMIN |
Exact Match (all same field name)
|
CHAPLAIN |
HP23 |
Chaplain |
Y=Checked, N=Not checked |
ADMIN |
Exact Match (all same field name)
|
HEALTH_ED |
HP23 |
Health Education and Information |
Y=Checked, N=Not checked |
ADMIN |
Exact Match (all same field name)
|
HEALTH_RESOURCES |
HP23 |
Health Care Benefits and Resources Information |
Y=Checked, N=Not checked |
OTHER |
Exact Match (all same field name)
|
IN_TRANS |
HP23 |
In Transition |
Y=Checked, N=Not checked |
ADMIN |
Exact Match (all same field name)
|
FAM_SUPPORT |
HP23 |
Family Support |
Y=Checked, N=Not checked |
ADMIN |
Exact Match (all same field name)
|
ONE_SOURCE |
HP23 |
Military one source |
Y=Checked, N=Not checked |
ADMIN |
Exact Match (all same field name)
|
TRICARE |
HP23 |
TRICARE PROVIDER |
Y=Checked, N=Not checked |
ADMIN |
Exact Match (all same field name)
|
VA_MED |
HP23 |
VA Medical Center or Community Clinic |
Y=Checked, N=Not checked |
ADMIN |
Exact Match (all same field name)
|
VET |
HP23 |
Vet Center |
Y=Checked, N=Not checked |
ADMIN |
Exact Match (all same field name)
|
OTHER_SUPPORT |
HP23 |
Other Supplemental services recommended |
Y=Checked, N=Not checked |
OTHER |
Exact Match (all same field name)
|
OTHER_SUPPORT_TEXT |
HP23 |
Other Supplemental services recommended text |
Text Field |
OTHER |
Exact Match (all same field name)
|
APPOINTMENT_NONE |
HP23 |
No Supplemental Services Required |
Y=Checked, N=Not checked |
ADMIN |
Exact Match (all same field name)
|
CERT_PROVIDER |
META |
Certify review process has been completed |
1=Checked, 0=Not Checked |
ADMIN |
Exact Match (all same field name)
|
HCP_DIG_SIG |
META |
HCP Digital Signature |
1=Signed, 0=Not signed |
PROVIDER |
Exact Match (all same field name)
|
CERTIFY_DATE |
META |
Date Certified |
YYYYMMDD |
ADMIN |
Exact Match (all same field name)
|