AF Form 3067: Intravenous Record – Complete Guide – AF Form 3067, officially titled Intravenous Record, is a standardized U.S. Air Force medical form used to document intravenous (IV) therapy administered to patients in Air Force Medical Treatment Facilities (MTFs) and related settings.
This form ensures accurate, detailed tracking of IV medications, fluids, and treatments, which is critical for patient safety, continuity of care, legal documentation, and compliance with Air Force medical standards.
What Is AF Form 3067?
AF Form 3067 (sometimes referenced as AF IMT Form 3067) is a dedicated Intravenous Record designed specifically for logging IV therapy. It was originally released on March 1, 1974, and remains part of the Air Force’s suite of medical documentation tools alongside forms like AF Form 3068 (PRN Medication Administration Record).
Healthcare providers in Air Force hospitals, clinics, and aeromedical evacuation units use it to record essential details of IV administrations. Proper use supports high-quality care and helps meet regulatory requirements outlined in Air Force instructions governing medical operations and documentation.
Purpose of the AF Form 3067 Intravenous Record
The primary purpose of AF Form 3067 is to create a clear, chronological record of all intravenous therapy given to a patient. This includes:
- Date and time of IV initiation and administration
- Patient identifiers and relevant medical information
- Type and amount of IV fluids or medications infused
- Infusion rates and durations
- Site of insertion and any observations or complications (such as infiltration, phlebitis, or reactions)
- Provider signatures and credentials
Accurate IV documentation protects patients by enabling quick review of treatment history, helps prevent medication errors, and serves as an official part of the medical record for audits, peer reviews, quality improvement, and potential legal or continuity-of-care needs.
In Air Force medicine, this form integrates with broader documentation practices referenced in manuals like AFMAN 44-144 and AFI 44-102, which cover medical operations and specific clinical workflows.
Who Uses AF Form 3067?
- Active Duty Air Force and Space Force medical personnel
- Civilian healthcare providers working in Air Force MTFs
- Reserve and Guard medical units during active duty or training periods
- Aeromedical Evacuation teams
- Nurses, physicians, physician assistants, and other credentialed providers authorized to administer or oversee IV therapy
It applies across inpatient, outpatient, and certain field or transport environments where IV therapy occurs.
Key Sections and How to Complete AF Form 3067
While the exact layout appears on the official PDF, typical fields on an Intravenous Record form include:
- Patient Information: Full name, rank/grade (if applicable), last four of SSN or DoD ID, date of birth, and unit or medical record number.
- Date and Time: For each entry or shift.
- IV Solution/Medication: Name of fluid (e.g., Normal Saline, Lactated Ringer’s) or medication, concentration, and volume.
- Rate and Volume Infused: Infusion rate (mL/hr) and total volume given.
- Site and Catheter Details: IV site (e.g., right antecubital, left forearm), gauge/size of catheter, insertion time, and condition of site.
- Observations/Complications: Any issues noted (redness, swelling, patency, patient tolerance).
- Start/Stop Times and Provider Information: Signatures, printed names, and timestamps for the initiating and monitoring personnel.
Best practices for completion:
- Document in real-time or as soon as possible after administration.
- Use black ink for handwritten entries (if not using electronic systems).
- Ensure legibility and completeness.
- Follow chain-of-command and facility-specific protocols for corrections.
- File the form in the patient’s medical record according to Air Force records management policies.
Always consult the current official form and your local MTF policies, as workflows may integrate with electronic health record (EHR) systems where available.
Official Download: AF Form 3067 PDF
You can download the current AF Form 3067 Intravenous Record directly from the official Air Force e-Publishing site:
This is the authoritative source. Check the Air Force e-Publishing portal (e-publishing.af.mil) regularly for any updates or revisions to forms.
Importance in Air Force Medical Operations
Proper use of AF Form 3067 supports several key areas:
- Patient Safety — Detailed IV records reduce risks associated with infusion therapy.
- Quality Assurance & Peer Review — Forms like this contribute to quarterly reviews and performance improvement processes in Air Force facilities.
- Compliance — Aligns with broader DoD and Air Force medical documentation standards, including those in AFI 44-102 (Medical Operations).
- Continuity of Care — Especially important during patient transfers, aeromedical evacuation, or shift changes.
Tips for Air Force Medical Staff
- Pair AF Form 3067 with related records such as intake/output worksheets or medication administration records for complete documentation.
- Train new personnel on accurate IV charting during orientation.
- Report any adverse events related to IV therapy through appropriate channels (e.g., patient safety reporting systems).
- When in doubt, refer to your facility’s nursing policy manual or consult the Medical Group’s education and training office.
Need the Form or More Guidance?
Visit the official Air Force e-Publishing website at https://www.e-publishing.af.mil/ and search for “AF3067” or “Intravenous Record” to access the latest version and related publications.
For questions specific to your unit or MTF, contact your supervisor, the nursing leadership, or the forms management office.
Note: This article provides general informational guidance based on publicly available sources. Always use the official form and follow current Air Force instructions, local policies, and clinical protocols. Medical documentation standards can evolve, so verify with e-publishing.af.mil for the most up-to-date resources.
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