CHECKLIST FOR 4A0
1. Make sure all documents are scan/file in to HAIMS/RECORDS
2. Check incoming emails for SGP mailbox.
3. Copy records to send to member
a. Paper record just copy and mail off
i. Put on copy of request form inside priority mail envelope and one keep for
record
ii. On Micro. Word type up address and print out and tape on envelope where
“To:” is and stamp unit address where “From” is
iii. Log in share drive on excel “Records logbook- FY18” under “member
Requested” tab
b. For member that want their records on a disc:
i. Look up in HAIMS
ii. Click on every lick
iii. Instead of click “open” click “save as”
iv. Save it to desktop
v. Once save to desktop
1. All file need to be password protected
2. Click on PDF
3. Click on file
4. Click on Properties
5. Go to security tab
6. Where it say “security method” change to “ password security”
7. Check “Require a password to open the document”
8. Enter password “last name all lower case, last 4
9. Click Ok
10. Reenter the password
11. Pop-up stating changes will not be safe until you close doc. and save
changes
12. Click Ok
13. Click Ok
14. Close file
15. Pop-up to save change click “yes”
vi. Put disc in
vii. Go to File Explorer
1. Go to “This PC”
2. Click on “DVD RW Drive”
3. Right click
4. Click “Format”
5. Pop- up click “start”
4.
5.
6.
7.
8.
6. Pop- up click “ok”
7. Pop-up Click “ok’
8. Once done close out
viii. Put all files that was save on desktop into “Disc Records”
ix. Open the DVD drive and Drag/drop all files from “disc records” into it
x. Once done take disc out
1. Put member name
2. Put Medical/Dental Records form JLV/HAIMS and Date
3. Put 301 MDS/NAS FW JRB
4. Print “privacy act” label and put on disc
xi. Print “70th Anniv Letterhead Memo STR electronic Format”
1. Change person name and date
2. Change contact info and signature
xii. Put disc in a blank paper fold in half and tape
xiii. Put in priority mail envelope (cardboard one without screen window)
xiv. Put one copy of request form in envelope and one to keep for record
xv. On Micro. Word type up address and print out and tape on envelope where
“To:” is and stamp unit address where “From” is
xvi. Log in share drive on excel “Records logbook- FY18” under “member
Requested” tab
Check for fax or email that need provider review:
a. Grab file and put it in cabinet
If new records arrive:
a. Log it into “Incoming records” under records log in shared drive.
b. Put 301 sticker on record to show what MTF the records belong to.
If a member need to get medical records from civilian doctor they need to:
a. Fill out 2870 release of info
b. We will fine fax number if not provided and fax it with “ fax cover sheet” under forms in
shared drive.
c. Scan/put in records all documents regarding to fax
If request for record to be sent to STR for VA claims:
a. Pull medical/dental records and replace it will green charge out stating record is in
HAIMS
b. Fill a 330 and in remark box put “ attention to SPOE”
c. Put in envelope put tracker and where the “TO:” sticker goes put “attention to SPOE” at
the very bottom of sticker
If records are needed to be sent to SA for retirement: (pull medical/dental records)
a. If it is on loss roster then see when effective date is
b. One day after effective date is when record can be sent to SA
c. 330, package, make sure there is a copy of their retirement orders (if applicable) , and
ship no need for green charge out
d. If before effective date pull replace with red charge out with paper stating it will be ship
soon and put record under the fliers.
e. After package make sure to log it under “loss roster” under records log in shared drive.
9. Put all 330 in binder
10. Go to mailroom at least once a week to mail out and pick up mail.
11. Certified Mails 60days letter:
a. Grab envelops from top cabinet where binders are.
b. Grab green certified mail stickers and green form 3811
c. Type up address on Word doc make sure to have three copy of address
d. On envelop stamp 301st address on left top corner, cut and tape member address in the
middle of envelops
e. On green form 3811 cut and tap member address under “Article Address to:” Stamp
301st address on the back in blank box under “Sender:”
f. Get green certified mail sticker and pill of the top of the stick where there is the tracking
number “0000 0000 0000 0000 0000” put it on form 3811 in box 2 beside “Article
name”
g. The part of the green certified mail sticker with barcodes goes on the envelop by the
301st address on left top corner.
h. The last copy of member address will be cut out and tape on the reminding part of the
green certified mail sticker. “U.S. Postal Service Certified Mail Receipt” Under “official
Use” by the “send to”
i. Close up envelop and pull off the white paper to tape the form 3811 on the back of the
envelop with the tracking and member address facing up.
j. Log tracking number in share drive under “Records logbook- FY18- Excel” in the “DAWG”
tab.
k. In “forms” folder on desktop open “certified mail form” adjust the “date”, “time”,
tracking number, and under box 9 “special service” leave everything just change the last
name ex: CALVIN----------------l. Fill all mails that is going out at the same time on one form after the last item put in the
next set of boxes “LAST ITEM------------------ LAST ITEM---------------------“
12. Out processing:
a. If they are retiring they must be green for at least 7months on everything and need a
copy of their separation/retirement orders.
b. Once order is in hand scan to HAIMS and add notes In ASIMS stating the retire date and
a copy of orders is in HAIMS. (ASIMS- look up member-under notes—click “Add New
Note)
c. If they are tdy for any reason (school, training, ect.) their leadership have to email Col
Morgan, SMSgt Johnson, and TSgt Estell requesting an approval for duty.
13. SHPE:
a. Members who are on extended orders if they are about to reach 180days they will get
an email stating they need a SHPE evaluation. They have to call the navy clinic to make
an appointment. This is so the AF know if they need any medical notation since they
have been on orders.
14. Dental:
a. Class 1 & 2 is green
15.
16.
17.
18.
19.
20.
21.
22.
b. Class 3 member must come to medical to see a dentist every UTA until the issue is
resolved. Member will be restricted to home station until issue is fix. (no 422 can be
done)
c. Class 4 member is just over due for dental
To Go Active Duty/ School/ TDY/ Transfer Unit (anything that needs a 422 done):
a. If member is at clinic they need to fill out 422 request form location in cubby box.
b. Member must have PULHES within 12months to request a 422 (only done during UTA)
c. Member must be green on IMR
d. If b and c are not meet then member must schedule an In-Person PHA with PULHES to
be done during UTA THIS MUST BE SCHEDULE BY 1200 WEDNESDAY PRIOR TO THE UTA
(IF THEY DO NOT MAKE IT BY DEADLINE THEY MUST SCHEDULE IT FOR THE FOLLOWING
UTA). MUST EMAIL THEIR UHM TO BE SCHEDULE. Once a PHA is done then a 422 can be
generated. Member can email .org box asking for appointment and attached 422
request form to it if not already given to Medical Record Tech.
i. To be able to schedule an In-Person PHA:
1. Member must be green in IMR
2. PHAQ must be done
3. Mental questionnaire must be done
4. BOMC must be done (must be done before in-person can be done.
BOMC will be done in one UTA and In-person will be schedule for the
following UTA)
5. Dental must be done
To Go Commission AD:
a. Step 15 must all be done before member can schedule a commission physical (done only
during UTA) this may take two UTAs to be able to get done. Commission physicals are to
be email into the .org box. We as records forward it to TSgt Estell to be schedule once
he put the member on the schedule he will email them.
In-Person PHA not at home unit
a. If member need to get an In-Person PHA at different unit they have to have their BOMC
and MHA done before they can go elsewhere (all green on IMR)
b. If another member from another unit want to come here to do PHA they must have the
same action done plus home unit need to contact us.
Dental/Audiogram
a. If member need to get dental done or an audiogram to be green on IMR
i. Audiogram:
1. 1430-1630 walk in at Navy Clinic Tuesday and Friday
MHA phone number:
a. 18886341128
b. 1-888-644-3100
Flight Physical:
a. Need to schedule with their UHM
If you get a cancer diagnose then the PMD must have a five year projection of treatment
(survival rate 5,10, ect years to live).
Org SOP:
a. Check org box daily
b. Once open an email take care of tasks
c. If tasks cannot be resolved
i. Forward tasks to SSgt Medina or SSgt Eral depend on who can accomplished the
task
ii. Color code and forward emails