Form Information

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FORM NUMBER:

DD771

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TITLE:

EYEWEAR PRESCRIPTION

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EDITION DATE:

19960701

CANCELLATION DATE:

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AVAILABLE FILE FORMATS:

PLEASE NOTE:

Fillable Adobe:

PDF

If no hyperlink appears next to a format, the form is not available electronically. To

Perform Pro:

PERF

obtain hard copies of current forms not available in electronic format, please contact

Form Flow 2.0:

FF 2.0

your own Military Service or DoD Component Forms Management Officer.

Form Flow 99:

Cancelled forms are not available in electronic formats. Click on link for a list of

Other:

Forms Management POCs.

Forms Management POCs

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REMARKS:

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ISSUANCES:

DODI 6040.35

NAVMEDCOMINST 6810.1

AFR 167-3

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SPONSOR / POC:

HA

SUB-SPONSOR:

HSO&R

NUMBER OF PAGES:

1

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USERS*:

A N AF

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PRESCRIBED OR ADOPTED?:

A

DISPOSITION:

S

FUNCTION CODE:

6040

FORM CONTROLLED:

N

MANDATORY PRINT SPECIFICATIONS:

Y

RCS:

IRCN:

OMB:

PRIVACY ACT IMPLICATIONS:

N

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* All revisions and/or cancellations must be coordinated through these USERS.

DISPOSITION: S = Do NOT use previous edition. U = Use previous edition until supply is depleted.