Privacy Act statement
Cites the Privacy Act of 1974 (5 U.S.C. Section 552a) and says the Social Security Number, authorized by Public Law 93-579 Section 7 (b) and Executive Order 9397, is used as a unique identifier.
SF600
Medical Record - Chronological Record of Medical Care
- Agency
- GSA
- Revision
- Rev. 9/2025
- Fillable fields
- 127
- Pages
- 2
- Official source
- GSA form page
- Checked
- October 20, 2026
Standard Form 600 (SF 600): Medical Record - Chronological Record of Medical Care
Standard Form 600 (SF 600), Medical Record - Chronological Record of Medical Care, is a two-sided medical record sheet, Rev. 9/2025. Its footer reads Prescribed by GSA/ICMR, FIRMR (41 CFR) 201-9.202-1, and GSA hosts a copy in its forms library. The form is marked CUI (When Filled Out), says the previous edition is not usable and says it is authorized for local reproduction.
The front opens with a Privacy Act statement, then a ruled table with a Date column and a wide column for symptoms, diagnosis, treatment and treating organization, headed (Sign each entry). Below the table are blocks for the hospital or medical facility, status, department or service, where the records are maintained, the sponsor and the patient's identification. The back continues the same table.
GSA's page says U.S. Government departments, agencies and offices can order printed copies through GSA Global Supply or GSA Advantage. You can fill it out free in your browser on this page and download the result without an account.
What's on SF 600
Date column
A narrow Date column at the left of each ruled row.
Symptoms, diagnosis, treatment, treating organization
A wide column for each entry, headed Symptoms, Diagnosis, Treatment, Treating Organization (Sign each entry).
Facility and sponsor blocks
Hospital or medical facility, status, department or service, records maintained at, sponsor's name, Social Security or ID number and relationship to sponsor.
Patient's identification
Name, ID Number or SSN, sex with male and female boxes, date of birth and rank or grade, next to a register number and a ward number.
Back of the form
The back repeats the Date and Symptoms, Diagnosis, Treatment, Treating Organization columns.
How to complete SF 600
- 1
Identify the patient
For typed or written entries, give the name (last, first, middle), ID Number or SSN, sex, date of birth and rank or grade, plus the register and ward numbers.
- 2
Fill in the facility and sponsor
Enter the hospital or medical facility, status, department or service, where the records are maintained, and the sponsor's name, number and relationship.
- 3
Date each entry
Enter the date in the Date column at the start of the row.
- 4
Write and sign the entry
Record the symptoms, diagnosis, treatment and treating organization. The column heading says to sign each entry.
- 5
Continue on the back
The back repeats the same Date and entry columns for more entries.
The form prints no instructions beyond its blocks. These steps follow them.
Why fill Form SF600 on indox
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Records, privacy and copies
Where it goes
The PDF gives no filing address or routing instructions. It has a Records Maintained At block.
Privacy
The form says this information may be provided to appropriate Government agencies when relevant to civil, criminal or regulatory investigations or prosecutions. It is marked CUI (When Filled Out).
Ordering printed copies
GSA's page says U.S. Government Departments, Agencies, and Offices can place an order at www.gsaglobalsupply.gsa.gov or www.gsaadvantage.gov with either a government purchase card or AAC (Activity Address Code). The Stock Number is 7540-00-634-4176.
Edition and prescribing rule
The footer reads STANDARD FORM 600 (REV. 9/2025), Prescribed by GSA/ICMR, FIRMR (41 CFR) 201-9.202-1, and says the previous edition is not usable. GSA's page lists the current revision date as 09/2025.
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Who uses SF 600?
The form does not say in words who fills it out. Its blocks and GSA's page name these people and places.
Official sources and the blank
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Questions about Form SF600
Who prescribes SF 600?
The footer reads Prescribed by GSA/ICMR, FIRMR (41 CFR) 201-9.202-1. GSA hosts a copy in its forms library.
Does each entry on SF 600 need a signature?
The main column is headed Symptoms, Diagnosis, Treatment, Treating Organization (Sign each entry).
Why does SF 600 ask for a Social Security Number?
The Privacy Act statement says the Social Security Number, authorized by Public Law 93-579 Section 7 (b) and Executive Order 9397, is used as a unique identifier to distinguish between employees with the same names and birth dates.
Can an older edition of SF 600 be used?
The form says the previous edition is not usable. The edition GSA hosts is STANDARD FORM 600 (REV. 9/2025), and it is authorized for local reproduction.
How can a federal office get printed copies?
GSA's page says U.S. Government Departments, Agencies, and Offices can order at www.gsaglobalsupply.gsa.gov or www.gsaadvantage.gov with a government purchase card or AAC. The Stock Number is 7540-00-634-4176.