DA Form 5028-R MEDCASE Form: Download & Guide

DA Form 5028-R MEDCASE Form: Download & Guide – DA Form 5028-R serves as a critical document in the U.S. Army’s medical logistics and equipment acquisition process. Known fully as the MEDCASE Support and Transmittal Form (LRA), it supports requests for high-value medical equipment under the Medical Care Support Equipment (MEDCASE) program.

This form ensures proper review, justification, and transmittal of equipment requests for Army Medical Treatment Facilities (MTFs). Military personnel, logistics officers, and medical facility administrators in the United States frequently use it.

Download the Official DA Form 5028-R PDF Here:
https://armypubs.army.mil/pub/eforms/DR_a/pdf/A5028_R.pdf

What Is DA Form 5028-R?

DA Form 5028-R is the MEDCASE Support and Transmittal Form (LRA). The proponent agency is the Office of The Surgeon General (OTSG), and users follow guidance in SB 8-75 MEDCASE.

MEDCASE stands for Medical Care Support Equipment. It is a centralized funding program that provides capital investment equipment (typically high-dollar items like imaging systems, laboratory analyzers, or other major medical devices) for fixed Army health care facilities worldwide.

The form acts as a transmittal and review document that accompanies equipment requests. It captures maintenance, engineering, information management, resource, and command-level approvals and assessments.

Purpose of the MEDCASE Support and Transmittal Form

The primary purpose of DA Form 5028-R is to standardize the submission and multi-level review of MEDCASE equipment requests. It ensures that:

  • Equipment needs are properly justified.
  • Maintenance, training, installation, and site preparation requirements are addressed.
  • Economic and resource considerations are verified.
  • All relevant stakeholders (logistics, engineering, radiology, resources management, and command) review the request.

This supports efficient allocation of Defense Health Program funds for major medical equipment while maintaining accountability and readiness in Army medical facilities.

Key Sections of DA Form 5028-R

The form includes several review blocks:

  • Activity and Asset Information — Activity name, asset control number.
  • Equipment Maintenance Activity — Maintenance support feasibility, annual costs, training needs, and replaced item details.
  • Equipment and Installation Characteristics — Installation requirements, electrical/support needs, and existing equipment status.
  • Review Blocks — Signatures and recommendations from:
    • Engineer (Health Facility Project Officer)
    • Information Management Officer
    • Resources Management Officer
    • Radiology Review (when applicable)
    • Logistics Review
    • Activity Commander
    • Regional Medical Command (RMC) Review

Each section requires specific details on costs, life expectancy, justification verification, and approval/disapproval recommendations.

How to Fill Out DA Form 5028-R?

  1. Complete Activity & Basic Info — Enter the medical facility (activity) and any existing asset control number.
  2. Maintenance Section — Indicate if maintenance support is feasible, estimate costs, specify training (one-time or recurring), and detail the item being replaced.
  3. Equipment Characteristics — Describe installation needs (turnkey, de-installation, electrical/power requirements).
  4. Obtain Reviews — Route the form sequentially for signatures from engineering, IM, resources, logistics, commander, and RMC levels.
  5. Certifications — Ensure the Logistics Chief certifies completeness and MEDCASE eligibility. The Commander recommends approval and disposition of replaced equipment.

Tip: Always refer to the latest SB 8-75 MEDCASE guidance and consult your local medical logistics or resource management office for current procedures. Use the official fillable PDF from Army Publishing Directorate.

Who Uses DA Form 5028-R?

  • Army Medical Treatment Facility (MTF) commanders and staff
  • Medical logistics officers and chiefs
  • Facility engineers and project officers
  • Resources management and information management personnel
  • Regional Medical Commands (RMC)
  • Personnel involved in the MEDCASE/SuperCEEP equipment acquisition process

It primarily targets U.S. Army healthcare facilities and supporting commands within the United States and overseas.

MEDCASE typically covers higher-value capital equipment. It works alongside the Capital Expense Equipment Program (CEEP) and SuperCEEP for planning, budgeting, and acquiring medical and non-medical equipment assets.

These programs help Army medical facilities maintain modern capabilities through Technology Assessment and Requirements Analysis (TARA) and centralized management by the U.S. Army Medical Materiel Agency (USAMMA).

Importance in Army Medical Logistics

Proper use of DA Form 5028-R ensures:

  • Compliance with Army medical logistics policies (AR 40-61 and SB 8-75 series).
  • Cost-effective acquisition and lifecycle management of critical medical equipment.
  • Patient care readiness through timely equipment modernization.
  • Thorough risk mitigation regarding maintenance, installation, and resource impacts.

Where to Get the Latest Version?

Always download the most current version from the official source:
Army Publishing Directorate – DA Form 5028-R

For policy details, consult SB 8-75 MEDCASE and AR 40-61 (Medical Logistics Policies). Contact your local MEDCOM or USAMMA representative for assistance with submissions.

This article is for informational purposes and does not replace official Army guidance or training. Procedures may be updated; verify with current publications.