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DA FORM 2807-1 PDF

DOD has replaced the use of the SF 93 with the DD Form and DD Form is used by recruiters to pre-screen applicants. Commissioned Corps of the U.S. Public Health Service. General Instructions for Completing Medical Examination Forms. DD “Report of Medical History” . A DD Form is a Department of Defense form is used for gathering medical information for applicants to military service. The form is used by military.

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DD Form Report of Medical History – Military Forms – |

Find one near you: Next provide your position, usual occupation, current medication, and allergies. All 3 Policies 3 DD Form An additional collection of information using this form occurs when a Medical Evaluation Board is convened to determine the medical fitness xa a current member and if separation is warranted. Showing results 1 – 4 Page 1 of 1.

The appearance of hyperlinks does not constitute endorsement by the Defense Health Agency of non-U. You are leaving Health. This is to see if you need further treatment or evaluations for any medical concerns. You must fill in the corresponding bubble for each medical issue. The examiner reviews your current health status and your complete medical history, including the DD Form The assessment results are then accessible by both the DoD and VA.

The primary collection of this information is from individuals seeking to join the Armed Forces. On the second page, provide your name and social security number at the top. Find fkrm military hospital or clinic Find a VA Facility. You may be complete it at a military hospital or clinic or at a VA facility.

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Go through each medical issue and answer yes or no for each. This becomes part of your record. The form is used by military physicians to determine if an applicant can be accepted or should be disqualified on medical grounds.

Government sites or the information, products, or services contained therein. You need only one exam.

Put the examining location on box 5, giving the address of the location. The examiner must sign and date the second page.

Questions 20 through 28 ask additional personal questions, which you must answer yes or foorm for each question.

A DD Form is a Department of Defense form is used for gathering medical information for applicants to military service. Boxes 10 through 19 ask you to indicate whether you have a history of specific medical conditions or illnesses.

First, fill out your basic information in boxes 1 through 4, providing your name, social security number, and contact information. Provide the information required in boxes 6 through 9, stating the military branch you are applying for, component, and purpose of the form. How do I file a VA disability claim?

The Frm Health Assessment documents and assesses your: The DD Form is now ready for submission to the Department of Defense for review of your medical history. The DD Form is available on the Department of Defense documentation website or can be supplied through the chain of command.

All your health records are shared with the VA. The information collected on this form is used to assist DoD physicians in making determinations as to acceptability of applicants for military service and verifies disqualifying medical condition s noted on the prescreening form DD Before filling out the DD Formyou must first read the disclaimer and understand that you must answer truthfully to all questions or face criminal charges.

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A physician must attest to your answers in boxes 10 through flrm Completed forms are covered by recruiting, medical evaluation board, and official military personnel file SORNs maintained by each of the Services.

How do I schedule the exam?

Separation Health Assessment

Medical history Medical concerns identified during your military career Current health status How It Works Schedule your exam at a military hospital or clinic or VA facility well in advance of your scheduled separation date. The DoD requires a separation history and physical flrm to capture the complete medical history of Service Members and evaluate members filing a disability claim.

A PDF reader is required for viewing. If you answer yes to any question in boxes 10 through 19, you must provide an explanation of the medical condition in the provided space in box 29 or attach additional sheets explaining each yes answer.

This may take a second or two. You can schedule the exam at any military hospital or clinic or VA facility.

Separation Health Assessment |

Close Window Loading, Please Wait! DoD and VA share results of the exam with each other. The physician may provide additional comments in box 30, adding additional information that they feel is important.