An official website of the United States government
A .mil website belongs to an official U.S. Department of Defense organization in the United States.
A lock (lock ) or https:// means you’ve safely connected to the .mil website. Share sensitive information only on official, secure websites.










 

COMPLETING DD FORM 2624

 

Download Blank DD Form 2624 >>

Click on Each Example to Show the Filled Out Form

  • EXAMPLE 1 (110 KB): Samples mailed to lab by BM2 Smith immediately after collection, with no intermediate transfer of custody.
  • EXAMPLE 2 (118 KB): Samples hand carried to lab by BM2 Smith immediately after collection, with no intermediate transfer of custody.
  • EXAMPLE 3 (127 KB): Samples mailed to lab by SN Jones with transfer of custody from BM2 Smith to SN Jones.
  • EXAMPLE 4 (126 KB): Samples mailed to lab by BM2 Smith after storage in locker #1 by BM2 Smith.
  • EXAMPLE 5 (129 KB): Samples mailed to lab by BM2 Smith after transfer of custody from SN Jones to BM2 Smith, and storage in locker #1 by BM2 Smith.
  • EXAMPLE 6 (119 KB): Example of forensically corrected SSN of specimen #004. The original SSN is still readable (has only a single line through it), and the correction is initialed and dated.


Web Resources
Clinicians

Clinical guidance, including recognition, management and clinical isolation guidance are generally covered by CDC: CDC Clinical Overview

Clinical management for Fleet medical personnel can be found in the NMCFHPC Fleet Mpox Medical Guidance

Clinical guidance for MTFs can be found in the DHA Mpox Guidance Update_5Sept2024

Currently, neither mpox testing nor treatment are readily available in a forward deployed operational setting. Units should identify suspected cases, isolate them, and move them for care at an MTF when operationally feasible.


Guidance-Card-Icon Dept-Exclusive-Card-Icon