DA Form 5512 Respite Care Agreement | Army EFMP Guide – Families in the U.S. Army facing the demands of caring for a loved one with special needs know how vital a break can be. DA Form 5512, officially titled the Respite Care Agreement, plays a key role in the Army’s Exceptional Family Member Program (EFMP). It formalizes temporary caregiving support to help military families recharge while ensuring safe, reliable care for their exceptional family member.
What Is DA Form 5512?
DA Form 5512 is a Department of the Army form used to document the agreement between respite care users (parents, guardians, or responsible family members) and the Army’s Respite Care Program under AR 608-75.
It outlines responsibilities, liabilities, and procedures for temporary care of individuals with disabilities or special needs. The form protects all parties by requiring clear communication of medical needs, emergency contacts, and care instructions.
Key details:
- Edition: September 2002 (current as of official Army publications).
- Proponent: Office of the Assistant Chief of Staff for Installation Management (OACSIM).
- For use with: AR 608-75 (Exceptional Family Member Program).
Who Uses DA Form 5512?
This form supports Army families enrolled in the EFMP, including:
- Active Duty Soldiers and their families.
- Army National Guard and Reserve families in eligible statuses.
- Families with children or adult dependents who have physical, emotional, developmental, intellectual, or medical special needs.
Respite care provides temporary relief (hourly, daily, or weekly) so primary caregivers can rest, attend to personal needs, or participate in family activities. Care can occur in the family’s home or an approved caregiver’s home.
Why Respite Care Matters for Military Families?
Caring for an exceptional family member adds unique challenges during PCS moves, deployments, and daily military life. The EFMP Respite Care Program:
- Reduces caregiver stress and burnout.
- Improves family stability and Soldier readiness.
- Offers care levels from basic supervision to personal care assistance.
- Complements other supports like TRICARE ECHO (Extended Care Health Option).
Respite care is a program benefit, not an entitlement — availability depends on local installation resources and eligibility. Families can request additional hours for exceptional circumstances.
How to Complete and Use DA Form 5512?
Approved EFMP respite care users must sign DA Form 5512. Families also typically provide DA Form 5191 (Information on Individual with Disability) to caregivers.
Main agreements in the form include:
- Releasing the Army/respite program from liability for incidents (with conditions).
- Providing complete medical instructions, medication details, emergency contacts, and physician information.
- Supplying clear descriptions of the individual’s special needs, likes/dislikes, habits, and routines.
- Making final decisions on specific caregivers.
- Informing coordinators about other household members needing care.
- Paying the agreed contribution directly to the caregiver upon completion of service.
- Allowing alternate caregivers if needed and providing performance feedback.
Download the official DA Form 5512 here:
https://armypubs.army.mil/pub/eforms/DR_a/pdf/A5512.pdf
Always use the official Army Publishing Directorate link for the most current, fillable PDF.
Steps to Access EFMP Respite Care
- Enroll in EFMP — Contact your installation Army Community Service (ACS) EFMP coordinator or medical provider. Complete required screenings (e.g., DD Form 2792).
- Register for Respite Care — Work with your local EFMP Respite Care Coordinator.
- Complete DA Form 5512 — Sign the agreement with the coordinator.
- Match with Caregivers — Trained providers (often background-checked) deliver services.
- Provide Feedback — Help maintain program quality.
Find your local EFMP support: Visit Military OneSource or your installation’s ACS office. Search by location at installations.militaryonesource.mil.
Additional Resources for Army Families
- Army EFMP Overview: myarmybenefits.us.army.mil
- Military OneSource Special Needs Support: 800-342-9647
- TRICARE ECHO Program: For additional respite and extended benefits.
- Army Regulation 608-75: Details full EFMP policies and procedures.
Note: Policies can vary slightly by installation. Contact your local EFMP coordinator for the most accurate, up-to-date guidance tailored to your situation.
DA Form 5512 ensures respite care is safe, transparent, and effective for Army families supporting loved ones with special needs. By formalizing this agreement, the Army helps caregivers maintain their well-being — ultimately strengthening family readiness and resilience.
If you’re an Army family member seeking respite support, download the form today and reach out to your installation EFMP team. Taking that first step can make a meaningful difference for your entire family.