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Enrollment Forms

Exceptional Family Member Program (EFMP) enrollment is mandatory and required immediately upon identification of a special need. The required forms for enrollment are:

DD Form 2792, Exceptional Family Member Medical Summary for medical issues only

DD Form 2792-1, Exceptional Family Member Special Education/Early Intervention Summary for educational issues.

All of the military services use the DD 2792 and DD 2792-1 Exceptional Family Member enrollment forms. The Air Force has one additional form, the AF Form 2523, the Special Needs Identification and Assignment Coordination Information Form that they require sponsors to read and sign when enrolling in the Air Force's Special Needs Identification and Assignment Coordination Process.

Instructions for Submitting Enrollment Forms to Other Military Services:

Service Instructions
Army Forward Completed DD 2792 and DD 2792-1 with any applicable attachments to any Army Medical Center to the attention of the EFMP Case Coordinator
Navy and Marine Corps

East of the Mississippi River in the continental United States, Europe, Africa, South America, and the Caribbean, forward the completed DD 2792 and DD 2792-1 with applicable attachments to: :

    Central Screening Committee (Code 60465C)
    Exceptional Family Member Program
    Naval Medical Center
    620 John Paul Jones Circle
    Portsmouth, VA  23708-2197
    Commercial (757) 953-5900

When the exceptional family member lives West of the Mississippi River in the continental United States and Alaska,  forward completed DD 2792 and DD 2792-1 to:

    Department of the Navy
    Naval Medical Center, Suite 100
    34520 Bob Wilson Drive
    San Diego, CA  92134-2100
    Commercial (619) 532-6910 

When the exceptional family member lives in countries in the South Pacific, Asia, and Hawaii,  forward completed DD 2792 and DD 2792-1 with applicable attachments to:

    EFM Central Screening Committee
    U.S. Naval Hospital Yokosuka
    PSC 475, Box 1, Code 121Y
    FPO AP  96350-1600
    Commercial 011-81-6160-43-5379
    DSN: 243-5379 
Air Force Forward completed DD 2792 and DD 2792-1 with any applicable attachments to any Air Force Medical Treatment Facility to the attention of the Special Needs Coordinator.
Coast Guard

Forward the completed DD 2792 and DD 2792-1 with any applicable attachments to:

Commandant (G-PWL-2)
Attn: Special Needs Program
2100 Second Street, SW
Washington, DC 20593



 
Release 09.24.12.1