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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.
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.
|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|
*Since these forms are DD Fillable forms, preview in browser will not be available. Please click on "download" above, and a message stating "Please Wait..." will appear. Use print or downward pointing arrow to download the document to your computer and use PDF previewer installed on your computer to view.
- April 28, 2021
- Special Needs Forum - Resources for Early Intervention and Beyond
EFMP Special Needs Forum - Resources for Early Intervention and Beyond
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