This page contains information on the Army Disease Reporting System internet (ADRSi).
What to report:
How to get an ADRSi account:
Before granting access to sensitive personal and health information, the Army requires command or unit-level assurance that the information will be handled in accordance with the Privacy Act and the Health Insurance Portability and Assurance Act (HIPAA). This requirement is documented on DD Form 2875; System Authorization Access Request (SAAR) and available via:
Completing DD Form 2875
Each User (defined as anyone desiring access to the ADRSi.) must submit the two page DD Form 2875 to the ADRSi Help Desk at APHC and be assigned an account before accessing the system. The ADRSi Administrator will maintain DD Form 2875 records for ADRSi Users. IMPORTANT: Users must provide notification to the ADRSi Administrator when they leave or transfer from their command/unit so their system access and User responsibilities can be terminated.
Indicate the Type of Request and Date
Add Location: (example: Belvoir Community Hospital)
Add System Name: Army Disease Reporting System-internet (ADRSi)
Complete Part I
Add User’s Name to Block 26 on page 2 of the form
Copy and paste the following text into Block 27 on page 2 of the form. (By signing the form in Block 11, the User agrees to comply with requirements contained in this text.)
(Begin copying here)
I understand that to ensure the integrity, safety and security of Army IT resources, when using those resources,
- Safeguard information and information systems from unauthorized or inadvertent modification, disclosure, destruction, or use.
- Protect Controlled Unclassified Information (CUI) and classified information to prevent unauthorized access, compromise, tampering, or exploitation of the information.
- Protect passwords for systems requiring logon authentication and safeguard passwords at the sensitivity level of the system for classified systems and at the confidentiality level for unclassified systems. Passwords will be classified at the highest level of information processed on that system.
- Virus check all information, programs, and other files prior to uploading onto any Army IT resource.
- Report all security incidents immediately in accordance with local procedures and CJCSM 6510.01 (series).
- Access only that data, control information, software, hardware, and firmware for which I am authorized access and have a need-to-know, and assume only those roles and privileges for which I am authorized.
- Be subject to monitoring, and further understand that there is no expectation or right to privacy over the data and communications generated through my use.
- Understand the information I'm viewing is for Official Use Only. Any misuse/unauthorized disclosure can result in civil/criminal penalty.
I further understand that, when using Army IT resources,
I shall not:
- Access commercial web-based e-mail (e.g. HOTMAIL, YAHOO!, AOL, etc.)
- Auto-forward official e-mail to a commercial e-mail account.
- Bypass, strain, or test IA mechanisms (e.g., Firewalls, content filters, anti-virus programs, etc.). If IA mechanisms must be bypassed, I shall coordinate the procedure and receive written approval from the Local IA Authority (CO or OIC).
- Introduce or use unauthorized software, firmware, or hardware on any Army IT resource.
- Relocate or change equipment or the network connectivity of equipment without authorization from my Local IA Authority.
- Use personally owned hardware, software, shareware, or public domain software without authorization from the Local IA Authority.
- Upload executable files (e.g., .exe, .com, .vbs, or .bat) onto Army IT resources without the approval of the Local IA Authority.
- Participate in or contribute to any activity resulting in a disruption or denial of service.
- Write, code, compile, store, transmit, transfer, or introduce malicious software, programs, or code.
- Put Army IT resources to uses that would reflect adversely on the Army (such as uses involving pornography; chain letters; unofficial advertising, soliciting or selling except on authorized bulletin boards established for such use; violation of statute or regulation; inappropriately handled classified information; and other uses that are incompatible with public service).
(End copying here)
(Part II must be completed and signed by a Supervisor delegated “By Direction” authority of the Commanding Officer/Officer in Charge.)
Complete Part II, Blocks 13 thru 20b.
Block 13 Justification for Access: Copy, paste and complete the following text:
a. The Requestor agrees to comply with block 27.
b. PROVIDE: the Reporting Unis(s) and the Name of the Clinic or Facility of the location for which Requestor will report or monitor Medical Event Reports:
c. HIPAA Training Date (MM/DD/YYYY):
Block 14 Type of Access Required: Authorized
Block 15 User Requires Access To: Other - Sensitive medical information
Submitting DD Form 2875 to the ADRSi Help Desk
We highly recommend the completed SAAR form is emailed to the DRSi HelpDesk since we do not have fax available.
EMAIL: Complete, print, sign, and scan the form, then send by email to: firstname.lastname@example.org.
If this option will not work in your current IT/communications environment, please contact the ADRSi HelpDesk by e-mail at email@example.com or by phone at 410-417-ADRS (2377) / DSN: 867-ADRS (2377).
ADRSi Account Activation
APHC will contact the official listed in Part II to verify the request. Once verification is complete, an account will be activated via phone or email. The User will then be able to login to the system to create a profile and finish setting up
*If form is emailed by the signing official in Part II - APHC will activate the local administrator account immediately.