2. Self-Referral If a Soldier initiates the mental health evaluation (self-referral), the PHI regarding the medical conditions that do not affect the Soldier’s fitness for duty or fitness to perform a particular mission will not be provided to the unit. Should the Soldier need to be hospitalized or prescribed medications that limit his or her ability to perform their duty, the healthcare provider has an affirmative duty to notify the unit of this change or limitation of duty status. As outlined above, MTFs and military healthcare providers will proactively inform command authorities of conditions that impair a Soldier’s performance of duty. Examples include to avert a serious and imminent threat to health or safety of a person, such as suicide or homicide if the Soldier’s medical condition could impair his or her ability to perform a specific mission or if the Soldiers injury indicates a safety problem or battlefield trend. E. Mechanics of a Request for PHI 1. General Information A commander or their proper designee can typically obtain information regarding a Soldiers general health status, adherence to scheduled appointments, profile status, and medical readiness requirements. Commanders can ask for this type of information over the phone after the commander’s identity is authenticated and they may also submit these requests in writing. The requests should clearly state the purpose for which specific medical information is sought. 2. Medical Records Requests for medical records should be in writing through a DA Form 4254, Request for Private Medical Information, to the MTF’s Patient Administrative Division. The servicing judge advocate can assist with such requests. 3. Authorized Designees If anyone other than the commander is to use the PHI, the commander must designate the authorized command official in writing. Commanders must use such delegations judiciously, and instruct each authorized designee about the importance of not further releasing the information without appropriate justification.