For Official Use Only

USG Warning and Consent Banner

You are accessing a U.S. Government (USG) Information System (IS) that is provided for USG-authorized use only. By using this IS (which includes any device attached to this IS), you consent to the following conditions:

  • The USG routinely intercepts and monitors communications on this IS for purposes including, but not limited to, penetration testing, COMSEC monitoring, network operations and defense, personnel misconduct (PM), law enforcement (LE), and counterintelligence (CI) investigations.
  • At any time, the USG may inspect and seize data stored on this IS.
  • Communications using, or data stored on, this IS are not private, are subject to routine monitoring, interception, and search, and may be disclosed or used for any USG-authorized purpose.
  • This IS includes security measures (e.g., authentication and access controls) to protect USG interests--not for your personal benefit or privacy.
  • Notwithstanding the above, using this IS does not constitute consent to PM, LE or CI investigative searching or monitoring of the content of privileged communications, or work product, related to personal representation or services by attorneys, psychotherapists, or clergy, and their assistants. Such communications and work product are private and confidential.

HIPAA Consent Banner

Registered RMIS users that are granted access to information that falls under the Health Insurance Portability and Accountability Act (HIPAA) must be compliant and current with HIPAA training. Materials provided in RMIS are provided solely for accident prevention purposes.



  • Have completed the necessary training with regards to Security Awareness and safeguarding Personally Identifiable Information.
  • Ensure that data is not posted, stored or available in any way for uncontrolled access on any media.
  • Ensure that data is protected at all times as required by the Privacy Act of 1974 (5 USC 552a(I)(3)) as amended and other applicable DoD regulatory and statutory authority; data will not be shared with offshore contractors; data from the application, or any information derived from the application, shall not be published, disclosed, released, revealed, shown, sold, rented, leased or loaned to anyone outside of the performance of official duties without prior USACRC approval.
  • Delete or destroy data from downloaded reports upon completion of the requirement for their use on individual projects.
  • Ensure data will not be used for marketing purposes.
  • Ensure distribution of data from a USACRC application is restricted to those with a need-to-know. In no case shall data be shared with persons or entities that do not provide documented proof of a need-to-know.
  • Be aware that criminal penalties under section 1106(a) of the Social Security Act (42 USC 1306(a)), including possible imprisonment, may apply with respect to any disclosure of information in the application(s) that is inconsistent with the terms of application access. The user further acknowledges that criminal penalties under the Privacy Act (5 USC 552a(I)(3)) may apply if it is determined that the user has knowingly and willfully obtained access to the application(s) under false pretenses.


AUTHORITY: 10 U.S.C. 7013, Secretary of the Army; 5 U.S.C. 7902, Safety Programs; Public Law 91-596, Occupational Safety and Health Act of 1970; DoD Instruction 6055.1, DoD Safety and Occupational Health Program; Army Regulations 385-10, Army Safety Program; DoD Instruction 6055 .07, Mishap Notification, Investigation, Reporting, and Record Keeping; and E.O. 9397 (SSN), as amended.

PRINCIPAL PURPOSE(S): Information collected is to provide the Army leaders, soldiers, families and civilians in injury, illness, and loss data to effectively manage its safety and occupational health program.

ROUTINE USE (S): In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act of 1974, these records or information contained therein may specifically be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 552a(b) as follows:

To the Department of Labor, the Federal Aviation Agency, the National Transportation Safety Board, and to Federal, State, and local agencies and applicable civilian organizations, such as the National Safety Council, for use in a combined effort of accident prevention.

In some cases, data must also be disclosed to an employee’s representative under the provisions of 29 CFR 196.29.

Records will be made available consistent with applicable laws and regulations. Information will be withheld from the public only if authorized by 5 U.S.C. Section 552 (Freedom of Information Act (FOIA), 5 U.S.C. 552a (Privacy Act), or other statutory or regulatory authority. For additional information for the types of records within this system, visit:

DISCLOSURE: Failure to provide all the required information on the report may result in the rejection of report submission.


The detailed step by step instructions for completing this form, is prescribed in DA Pamphlet 385-40, as directed by AR 385-10, for the implementation instructions for the investigation and the reporting of Army accidents and incidents; DA Pam 385-40 can be found at:

For Official Use Only
RMIS2 Version