Enclosure (3) to COMDINST 1750.4D
Ombudsman Initial Command Briefing Checklist
Ombudsman shall complete an initial command brief before the performance of official om_ud_man dutbudsmbrn fapplalcation
b _ s _Omies. This a ie ing sh i l
be completed by the time of or in conjunction with the appointment of the ombudsman. The Ombudsman shall initial each topic
area after discussion. The Commanding officer and the ombudsman shall sign and date this checklist and forward a copy of this
completed checklist, along with a copy of the appointment letter to the servicing ISC ombudsman coordinator.
_____Interview date: ______________;
_____Complete part I & II of DD Form 2793, Volunteer agreement (replace SF-50
Personnel Action Request);
_____Appointment letter from the command provide original to ombudsman, copy in
administrative file, copy to ombudsman program supervisor;
_____Brief on local command structure and overview of missions of local command;
_____Provide command point of contact names and contact numbers;
_____COMDTINST 1750.4D Ombudsman Program provide a copy of this instruction;
_____COMDTINST 1750.7 Family Advocacy Program provide a copy of this
instruction
_____Local reporting requirements for abuse issues, emergencies, etc. name and contact
information for family advocacy specialist; ombudsman are mandatory reporters;
other emergency command numbers; when to notify the CO
_____Confidentiality the protection of the command roster; and guidance of this
instruction discussed;
_____Provide command roster - CO decides information on the roster, remove social
security numbers, if necessary, replace with another confidential identifier such as
employee ID numbers, if possible;
_____Administrative support POC for ombudsman admin support, supplies; procedures
to obtain supplies, work space and other support;
_____Expense reimbursements procedures advance approval of reimbursable expenses
_____Ombudsman Coordinator and program supervisor name and contact information
_____Annual ombudsman training is required; refer to ombudsman coordinator for date
and time;
_____Order a name tag from the local uniform distribution center blue military name
tag with Ombudsman name on first list, and command name followed by the word
ombudsman on the second line.
_____Ombudsman service hours and reporting data ombudsman shall complete and
forward to commanding officer monthly.
Other topics:________________________________________________________
___________________________________________________________________
Ombudsman Printed Name
Ombudsman Signature:
Date:
Command Representative Printed Name
Command Representative Signature
Date:
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