Enrollment & Forms

Enrolling in the Exceptional Family Member Program, requires completion of Form DD2792 (Exceptional Family Member Medical Summary). The form is completed by both the sponsor or parent and a qualified medical provider.

Any child identified or requiring services through an Individualized Family Support Plan (IFSP), or an Individualized Education Plan (IEP) are required to complete Form DD2792-1, in addition to the Medical Summary (Form DD2792).

A sponsor or family member may decline case management services provided by the local EFMP installation. If the sponsor or family member so chooses, he or she must sign an EFMP Declination of Services form. Once the Declination of Services form is processed, the local EFMP office will have no further contact with the individual or family. All future contacts will be conducted through HQMC.

Updates

Every 3 years, Exceptional Family Members are required to update their conditions by resubmitting a completed DD2792 to the local EFMP office. The update provides HQMC the opportunity to reevaluate the original condition. Children receiving services through an IFSP or IEP must complete Form DD2792-1as well.

FORMS
Informational EFMP Eligibility Requirements Download
Guidelines for completing Family Member Medical Summary DD 2792 Download
Form DD 2792 Family Member Medical Summary Download
Guidelines for completing Special Education/Early Intervention Summary DD 2792-1 Download
Form DD 2792-1 Special Education/Early Intervention Summary Download

 

Join us as we welcome our new team members, Bianca Ramirez- EFMP Manager, and Maria Zamorano- Family Care Branch Manager as we learn about all of the great things that the Exceptional Family Member Program has to offer. Visit our Lending Library, which offers complimentary check-out on items. Light refreshments and bagels will be served.

This event is open to base patrons.

EFMP Meet and Greet
September 20th, 2019
9am-11am
Bldg. 1085 | 269-2949