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Enrollment Form 

 EFMP Enrollment Form

EFMP enrollment is mandatory and required immediately upon identification of a special need.

Please use DD Form 2792, Exceptional Family Member Medical and Educational Summary and DD Form 2792-1, Exceptional Family Member Special Education/Early Intervention Summary to complete this process.

 

Every Military Treatment Facility (MTF) appoints an EFMP Coordinator to facilitate the enrollment process.  Coordinators provide enrollment forms, offer help in the preparation of the forms, review completed forms for accuracy, and forward the enrollment package to the Central Screening Committee (CSC).  If you are not located near an MTF, forms may be available from one of the following locations:

  • Fleet and Family Support Centers (FFSC) Personnel Support Offices
  • Navy Liaison Offices
  • Navy Personnel Command (NPC) EFM Program Managers(PERS-456) in Millington, Tenn.

 

Both medical and educational portions must be completed for school-aged children.  The treating physician(s) should complete the medical forms.

 

An official at your child’s school must complete Addendum B Special Education.

 

Review the forms before signing.  You are responsible for their completeness and accuracy.

 

Return the completed forms to the MTF.  The Coordinator will review and sign the forms and forward them to a CSC.

 

In areas with no MTF or EFMP Coordinator, you should mail the EFMP application forms (with other required documentation attached) to the appropriate CSC.

 

 

CENTRAL SCREENING COMMITTEE (CSC)

 

Forward completed applications to the appropriate Central Screening Committee. The CSC that will review your application is determined by the location of your current duty station.

 

CSC locations:

 

 

1.  East of the Mississippi River in the continental United States, Europe, Africa, South America, and the Caribbean:

 

    CENTRAL SCREENING COMMITTEE (CODE 60465C)

    EXCEPTIONAL FAMILY MEMBER PROGRAM

    NAVAL MEDICAL CENTER

    620 JOHN PAUL JONES CIRCLE

    PORTSMOUTH VA  23708-2197

    Commercial (757) 953-5900

 

 

2.  West of the Mississippi River in the continental United States and Alaska, South Pacific, Asia, and Hawaii:

 

    DEPARTMENT OF THE NAVY

    NAVAL MEDICAL CENTER SD

    34520 BOB WILSON CODE CGH

    SAN DIEGO CA  92134-2102

    Commercial (619) 532-8586

 

 

Sample EFMP Enrollment Letters

 

 

Please use this sample, fillable Enrollment Letter or this Respite Care Enrollment Letter.

 

 

NAVY PERSONNEL COMMAND: 5720 Integrity Drive, Millington TN 38055-0000 
Comments? Suggestions? Call 866-U-ASK-NPC or Email the Webmaster | Updated:4/15/2015 8:39 AM 


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