AF Form 2110B: Lt Green Dental Health Record Jacket

AF Form 2110B: Lt Green Dental Health Record Jacket – The AF Form 2110B, officially titled Health Record – Dental (Lt Green), serves as a specialized dental health record jacket used exclusively by United States Air Force (USAF) Medical Treatment Facilities (MTFs) and Dental Treatment Facilities (DTFs). This light green folder is part of the standardized series of AF Form 2100B–2190B dental record jackets, which organize and protect paper dental documentation for active duty, reserve, guard, family members, and other authorized beneficiaries.

What Is AF Form 2110B and Why Does the Color Matter?

USAF dental records use a color-coded terminal digit filing system based on the last two digits of the patient’s Social Security Number (SSN) or pseudo-SSN. This system ensures efficient retrieval and filing in busy military dental clinics.

  • AF Form 2110B (Lt Green): Assigned to patients whose SSN ends in 10–19.
  • Other colors in the series include:
    • Orange (AF Form 2100B): 00–99
    • Yellow (AF Form 2120B): 20–29
    • And so on through Pink (AF Form 2180B) and Red (AF Form 2190B).

The light green jacket provides a durable, standardized outer folder for the Service Treatment Record (STR) dental portion. Inside, providers file key documents such as:

  • SF 603 (Health Record – Dental)
  • SF 603A (Health Record – Dental Continuation)
  • AF Form 935 series (dental treatment summaries or related forms)
  • Radiograph envelopes
  • AF Form 696, DD Form 2005, and other intake/authorization forms
  • Active treatment plans and MHS GENESIS printouts

This color-coded approach supports quick identification during in-processing, deployments, PCS moves, or record transfers.

Purpose and Authorized Use

AF Form 2110B is designated “For use by USAF Medical Treatment Facilities ONLY.” It maintains a chronological record of a patient’s dental health, examinations, treatments, and readiness status while receiving care in Air Force dental facilities.

Key purposes include:

  • Documenting dental examinations, prophylaxes, restorations, extractions, and other procedures.
  • Supporting dental readiness for deployment and worldwide qualification.
  • Facilitating continuity of care during permanent change of station (PCS), separation, or retirement.
  • Complying with DoD and Air Force policies on health record management (e.g., DHA-PM 6025.02, AFMAN 41-210, and related guidance).

Note: This form is not available for general public download or personal use outside official USAF MTF/DTF channels. The provided links (https://static.e-publishing.af.mil/etc/physical.pdf and .epub) point to Air Force e-Publishing resources, but the actual form jackets are issued and managed internally by dental records sections.

Who Uses AF Form 2110B?

  • USAF Dental Assistants and Administrative Staff: For initiating, filing, labeling, and transferring records.
  • Dental Providers: To document care on enclosed SF 603/603A forms.
  • Patient Administration (TOPA/Records Sections): During in/out-processing, deployments, or ROI (Release of Information) requests.
  • Commanders and Readiness Personnel: To verify dental readiness metrics.

Records are established for all Service members and other beneficiaries receiving care at USAF facilities. Dental health records belong to the U.S. Air Force, though patients have rights to access copies under HIPAA and DoD privacy rules.

How Dental Records Are Managed (Key Procedures)?

  1. Initiation: Upon first visit, staff confirm patient ID and DEERS eligibility, have the patient complete required forms (e.g., AF Form 696, DD Form 2005), and select the correct colored jacket (Lt Green for 10–19 terminal digits).
  2. Labeling: Use black ink or felt-tip marker for:
    • Patient name (last, first, MI)
    • SSN/FIN (with last digit obscured per privacy rules)
    • FMP/relationship code
    • Service/grade, PRP/Fly indicators (if applicable), and facility stamp
  3. Filing Contents: Fasten documents inside the jacket in proper order. Include radiograph envelopes and any MHS GENESIS outputs (the DoD’s electronic health record system replacing older platforms like AHLTA).
  4. Transfers: During PCS or separation, dental records move with the Service Treatment Record per AFMAN 41-210 and local supplements. Timelines are strict (often within a few duty days).
  5. Privacy and Security: All handling complies with HIPAA, DoDM 6025.18, and Air Force privacy policies. Sensitive duties (e.g., PRP) require additional markings like AF Form 745.

Modern records increasingly integrate with MHS GENESIS, but paper jackets like AF Form 2110B remain important for certain legacy or supplemental documentation.

How to Request Copies of Your Dental Records (For USAF Personnel & Veterans)?

Active Duty / Current Beneficiaries:

  • Contact your local USAF Dental Clinic Records section.
  • Submit DD Form 2870 (Authorization for Disclosure of Medical or Dental Information).
  • Many facilities allow requests via the MHS GENESIS Patient Portal or in person.

Veterans / Separated Personnel:

  • Records location depends on separation/retirement date.
    • Before ~1994: National Archives.
    • 1994–2013: VA Records Management Center.
    • On/after 2014: AF STR Processing Center or appropriate DHA channel.
  • Use DD Form 2870 or SF 180 for broader military records requests. Submit via the TRICARE Online portal, email, fax, or mail to the correct custodian.

Privacy Note: Always use official channels. Unauthorized release of protected health information (PHI) is strictly prohibited.

  • SF 603 / SF 603A: Core dental examination and treatment continuation sheets.
  • AF Form 1466D: Dental Health Summary (often used for deployments or separations).
  • DD Form 2870: Required for most record releases.
  • MHS GENESIS Patient Portal: For viewing electronic portions of your health record.
  • Official source: Air Force e-Publishing for policies like AFMAN 41-210, AFI 47-101 (Managing Air Force Dental Services), and DHA guidance.

Why Proper Dental Record Management Matters?

Accurate, well-maintained dental records directly impact:

  • Deployment readiness — Untreated dental issues can ground Airmen.
  • Continuity of care during moves or transitions to VA care.
  • Legal and benefits processes, including disability claims.

USAF dental teams follow strict protocols from AFI 47-101, patient administration manuals, and DoD health record policies to ensure records are complete, legible, and secure.

Important: This article provides general information based on publicly available USAF policies and training materials as of 2026. Always consult your local USAF Dental Treatment Facility or official e-Publishing resources for the most current guidance, as forms and procedures can be updated.

For official access to AF Form 2110B or related dental record support, visit your base dental clinic or the Air Force e-Publishing website. If you are a veteran seeking records, refer to the National Archives or VA resources for assistance.

Keywords: AF Form 2110B, USAF dental health record, Lt Green dental jacket, AF 2110B, military dental records, Service Treatment Record dental, USAF MTF forms, DD Form 2870 dental records.