CUI // PRVCY — Demonstration environment · notional data only
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Pre-Deployment Health Assessment

DD FORM 2795 · OCT 2015 Forms menu
Deployer: SMITH, Dana R.Source
DEERS · verified at sign-in · 02 Jul 2026
SSN (last 4): •••• Deploying: ≤120 days Est. date: 15 Aug 2026 Demo sex:
Pre-filled from your record — last PHA (21 Jul 2025) · deployment roster · MHS GENESIS · immunization registry (ITS). Hover ⓘ on a pre-filled value for its source. Anything you change is kept and flagged for clinical review — your answer never silently overwrites the record.
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