DA Form 4108: Register of Operations Guide (2026)

DA Form 4108: Register of Operations Guide (2026) – DA Form 4108, titled Register of Operations, is an official U.S. Army form used to maintain a chronological record of all surgical procedures performed in operating rooms (OR) and certain other procedural areas within military treatment facilities (MTFs).

It serves as a centralized log that transcribes key information from the DA Form 4107 (Operation Request and Worksheet). This ensures accurate tracking of surgical activity for statistical, research, accreditation, staffing, and resource allocation purposes.

Purpose and Importance of the Register of Operations

The primary purpose of DA Form 4108 is to create a reliable, permanent register of every surgical procedure. Accuracy and completeness are critical because the form supports:

  • Statistical computations and workload reporting
  • Research and quality improvement initiatives
  • Feeder reports to higher headquarters
  • Hospital accreditation (e.g., Joint Commission)
  • Justification for staffing and space requirements

In Army medical facilities, this register helps maintain operational readiness and compliance with medical record administration standards outlined in AR 40-66.

Who Uses DA Form 4108?

  • Operating Room (OR) staff in Army Medical Treatment Facilities
  • Departments performing surgical or anesthesia-supported procedures outside the main OR suite (e.g., obstetrics, urology, cardiology, plastic surgery, dental clinics)
  • Medical records administrators and surgical services leadership

Each relevant department or service maintains its own DA Form 4108 when procedures occur outside the central OR.

How to Complete DA Form 4108?

Information is transcribed from the completed DA Form 4107. Key entry guidelines include:

  • Hospital: Enter the name and location.
  • OR Number: Indicate #1, #2, #3, etc.
  • Emergency: Mark with an “X” for emergency procedures.
  • Case Number: Sequential numbering within each OR for the day/month.
  • Surgeon(s): List the primary surgeon first, followed by assistants in order.
  • Combat: Use approved abbreviations for injuries from hostile fire.
  • Nursing Time: Record start and end times from DA Form 4107.
  • Counts: Indicate “C” (correct) or “IC” (incorrect) for sponge, needle/sharp, and instrument counts.

Entries may be typed or handwritten (if legible) and are adaptable for computer input. Pages are arranged chronologically with monthly tallies.

Error Correction: Draw a single line through incorrect entries, initial above the line, and enter the correction afterward. Erasures are prohibited.

Arrangement and Maintenance Requirements

  • Use official covers available through supply channels for yearly binders.
  • Number pages sequentially; use both sides of each sheet.
  • Sequence starts at #1 for the first procedure after 0001 on the first day of the month.
  • Maintain monthly subtotals and carry forward cumulative totals.
  • Add tabs for easy monthly identification.

Retention and Disposition

DA Form 4108 binders are typically retained for extended periods to support accreditation cycles, statutes of limitations, and local policy. Consult current AR 40-66 and facility-specific guidance for exact disposition instructions.

  • DA Form 4107: Operation Request and Worksheet (source document)
  • DA Form 7001: Operating Room Schedule
  • DA Form 5179 / 5179-1: Preoperative/Postoperative and Intraoperative Nursing Documents
  • DD Form 1924: Surgical Checklist

Accurate completion of DA Form 4107 directly impacts the quality of the DA Form 4108 register.

Best Practices for U.S. Army Medical Facilities

  1. Ensure real-time or prompt transcription from DA Form 4107.
  2. Conduct regular audits for completeness and accuracy.
  3. Train all OR and procedural area staff on proper entry and correction procedures.
  4. Integrate with electronic systems where possible while maintaining the official register.
  5. Use the register for monthly/annual surgical volume reporting and performance improvement projects.

Note: Always refer to the most current version of AR 40-66 and local Standing Operating Procedures (SOPs) for any updates, as medical documentation standards evolve.

Download and Resources

Official DA forms are available through the Army Publishing Directorate (APD) or your facility’s forms management system. For training or questions, consult your Medical Records Department or Surgical Services leadership.

This guide is for informational purposes and is based on established U.S. Army medical regulations. Policies may be updated; verify with official sources for compliance.