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 conditions noted on the prescreening form dd 2807 2. The way to complete the online 2807 2 on the internet. Dod medical forms 28071, 28072, and 2808 used by recruiters. Army publishing directorate army publishing directorate. Dd form 28072 download fillable pdf or fill online accessions. A dd form 2807 1 is a department of defense form is used for gathering medical information for applicants to military service. Dd form 28071 is often used in dd 2807 forms, dd forms, u. Dd form 28072, accessions medical prescreen report, march 2015. Fill out the accessions medical prescreen report online and print it out. Sign, fax and printable from pc, ipad, tablet or mobile. Military physicians determine if an applicant can be accepted or should be disqualified on medical grounds with the help of it. Fill out the report of medical history online and print it out for free.
Chronic or recurrent intestinal problem of the small or large bowel such as irritable bowel syndrome, crohns disease. Dd form 28071, report of medical history, october 2003. Dd form 2808 is used by the meps medical staff to document the medical examination. The recruiting service liaison office must, in turn, submit the dd form 28072 and any required medical documentation to the meps prior to the submission deadline. I am just applying for commission as an officer and im not even sure what program im looking for at this point. Notes continued and significant or interval history use additional sheets if necessary. Dd form 2808, report of medical examination, october 2005.
Read online dd form 28072, medical prescreen of medical history. A dd form 2807 1 is a department of defense form which is used to gather medical information for applicants who need to accept military service. Dd form 28071, aug 2000 page 2 of 3 pages last name, first name, middle name suffix social security number b. Arnghrr october 2015 memorandum for ng j1 rrf all. Dd forms 25002999 updated 02192020 form availability. Army navy marine corps air force active duty reserve national guard. Nervous trouble of any sort anxiety or panic attacks e. This version of the adobe acrobat is not compatible with the apd website.
Army da administrative publications and forms by the army publishing directorate apd. The green to gold scholarship program is a program that provides eligible, regular army ra enlisted soldiers an opportunity to complete their first baccalaureate degree or. Download fillable dd form 28071 in pdf the latest version applicable for 2020. The latest technologies high quality electronic pubs and forms view u. The advanced tools of the editor will guide you through the editable pdf template. The dd forms 28071, 28072, and the 2808 connect the military recruiters office, meps, and. The dd forms 28071, 2807 2, and the 2808 connect the military recruiters office, meps, and the applicant seeking to join the military to one another by disclosing medical history information of the recruit. Additional questions have been added to improve its usefulness to the accessions medical prescreening process. I am in the delayed entry program for the army and was told not to tell meps i had been to court when i was 14. Complete online, sign, save and send your documents in a few clicks.
Aug 31, 2003 dd form 2807 1, aug 2000 page 2 of 3 pages last name, first name, middle name suffix social security number b. Va separation health assessment for service members factsheet. If this message is not eventually replaced by the proper contents of the document, your pdf viewer may not be able to display this type of document. Dec 10, 2008 i have a lot of questions about the dd form 2807 2. Age 46 civil conviction 52 standardized test scores 56. Applicants who processed prior to 19 october 2015 with the previous version of the dd form 28072 are grandfathered. The dd forms 2807 1, 2807 2, and the 2808 connect the military recruiters office, meps, and the applicant seeking to join the military to one another by disclosing medical history information of the recruit.
Replaces the existing medical prescreen form dd form 28072 aug 2011. Reading aloud test dd form 2808, oct 2005 page 2 of. I have a question regarding question 8 on the dd form. Use this stepbystep guide to complete the 2807 2 army 20152019 form promptly and with ideal precision. Dd form 28072 is used by recruiters to prescreen applicants. Department of defense, army forms, business, united states federal legal forms and united states legal forms. Reference each item on the form to which the remark pertains. Arnghrr 25 july 2018 memorandum for ng j1 rrf all entire rrf. Dd form 28072 medical prescreening of medical history report. This form is to be completed by each individual who requires medical processing in accordance with department of defense instruction dodi.
Pdf, reserve component survivor benefit plan rcsbp election certificate dd form 26566. Control number has been issued and is annotated within the dd 19664 remarks page. Age 46 civil conviction 52 standardized test scores 56 cgpa 58. Laboratory tests may be required, as well as an eye exam, hearing test, and dental exam. Dd form 2807 2 fill out and sign printable pdf template signnow. Download dd form 28072, medical prescreen of medical history. Failure to sign the authorization form will result in the nonrelease of the protected health information. Page 3 of form dd2808 name and emplid at top of pagemust be completed. It seems a majority of the posts i have read, seeking some advice, are posted by people who want to be pilots.
Military entrance processing command usmepcom with health history information necessary to identify. This form has not been set up to work with a texttospeech reader. Tooth or gum problems other than cavities dd form 2807 2, mar 2015 44. Contact the department of defense forms manager for further details if this access is required.
Dd form 28071, report of medical history, 20160516 draft. Completed forms are covered by recruiting, medical evaluation board, and official military personnel file sorns. The latest technologies high quality electronic pubs and. Start a free trial now to save yourself time and money. Dd, record of military processing armed forces of the united states. Download fillable dd form 2807 1 in pdf the latest version applicable for 2020. Page 1 of 9 instructions for completing dd form 28072, accessions medical history report. The primary collection of this information is from individuals seeking to join the armed forces. The most secure digital platform to get legally binding, electronically signed documents in just a few seconds. This form will not be used for the authorization to disclose alcohol or drug abuse patient information from medical records or for authorization to disclose information from records of an alcohol or drug abuse treatment program. 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 conditions noted on the prescreening form dd 28072. Double check all the fillable fields to ensure complete precision.
Dd form 28071, oct 2003 dod exception to sf 93 approved by icmr, august 3, 2000. To download a document, rightclick on the link and select save target as. Dd form 2807 1 is often used in dd 2807 forms, dd forms, u. A dd form 28071 is a department of defense form is used for gathering medical information for applicants to military service. Replaces the existing medical prescreen form dd form 2807 2 aug 2011. An additional collection of information using this form occurs when a medical evaluation board is convened to determine the medical fitness of a current member and if separation is warranted. Create a free dd 2808 form in minutes with our professional document builder. Page 1 of 9 instructions for completing dd form 2807 2, accessions medical history report. Purpose of examination enlistment commission retention separation medical board retirement. Dd form 28071 report of medical history legal forms. Effective 19 october 2015, dd form 2807 2 dated 2 march 2015 is the only authorized version for use. Dd form 28071 download fillable pdf or fill online report. The form is used by military physicians to determine if an applicant can be accepted or should be disqualified on medical grounds. May 28, 2019 admin may 28, 2019 may 28, 2019 no comments on dd 28072 pdf dod has replaced the use of the sf 93 with the dd form and dd form is used by recruiters to prescreen applicants.
Dd form 28071, oct 2003 page 3 of 3 pages last name, first name, middle name suffix social security number 30. I have a question regarding question 8 on the dd form 28072, this question is to assess learning, psychiatric, and answered by a verified military lawyer. Download dd form 2807 2, medical prescreen of medical history. General instructions for completing medical examination forms. The individual completing the dd form 2807 2 will submit the form, at a minimum, 1 processing day in advance to the meps projected to process the individual. The form is designed to assist recruiters in the medical prescreening of applicants. Examineeapplicantwill be used by some military facilities. To obtain hard copies of current forms not available in electronic format, please contact your own military service or dod component forms management officer. The meps medical department will require the applicant to provide supporting documentation regarding the applicants health history in the form of health records in conjunction with the dd form 28072 as specified in the usmepcom medical prescreen documents. A dd form 28071 is a department of defense form which is used to gather medical information for applicants who need to accept military service. Medical providers are the designated dod medical authority that determine if an applicant meets the requirements of title 10 to be considered medically qualified. Tooth or gum problems other than cavities dd form 28072, mar 2015 44. Its used by meps during the meps medical examination.
Dd form 28072, accessions medical prescreen report. Read online dd form 2807 2, medical prescreen of medical history. Dd form 28072, medical prescreen of medical history. Army navy marine corps air force active duty reserve national guard c. Dod medical forms 2807 and 2808 used by recruiters meps. Utilize the sign tool to create and add your electronic signature to certify the dd form 2807 2 print. Dd form 28072, medical prescreen of medical history report. This form is to be completed by each individual who requires medical processing in accordance with army regulation 40501 chapter 2 standards, or department of defense directive 6. Public health service\ngeneral instructions for completing medical examination forms dd28071 report of medical.
If the form number does not have a hyperlink, the form is not available electronically. Pdf, survivor benefit plan election change certificate dd form 28071. Dd form 28071 download fillable pdf or fill online report of. Certifying official ensures a copy of the completed dd form 368 and a copy of the oath are mailed to the address in item 6. All books are in clear copy here, and all files are secure so dont worry about it. Dd1966, record of military processing armed forces of the united states. Smom 16005, implementation of dd form 2807 2 accessions medical prescreen report, dated 2 march 2015 1. Loss of memory or amnesia, or neurological symptoms 17. A dd 2808 form will include the date of the exam, the name and personal information of the party being examined, and evaluations from the medical examination. Va separation health assessment for service members. Defense counsel must carefully screen clients contracting documents for a dd form 28072 before submitting affidavits and medical history in support of requests and motions for expert assistance. This form is to be completed by each individual who requires medical processing in accordance with army regulation 40501.
75 115 1105 1534 197 1014 696 334 603 360 1347 962 1361 790 375 1239 682 43 1413 637 828 1420 835 563 909 808 102 456