Active Duty Dental Program Claim Form

The information collection is necessary to obtain and record the dental readiness of Service Members using the Active Duty Dental Program (ADDP) and at the same time submit the claim form for the dental procedures provided. Many of these Service Members are not located near a military dental clinic and receive their dental care in the private sector under ADDP. The form is needed to update the dental readiness of all Service Members so that they can maintain worldwide deployment status and reduces paperwork by combining the dental claim and dental readiness into one form.

The latest form for Active Duty Dental Program Claim Form expires 2023-01-31 and can be found here.