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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At your exam, the examiner reviews your answers and ensures claimed contentions are addressed in the exam report.

The physician may provide additional comments in box 30, adding additional information that they feel is important. You can schedule the exam at any military hospital or clinic or VA facility. The information collected on this form is used to assist DoD physicians in making determinations as to acceptability of applicants for military service and rorm disqualifying medical condition s noted on the prescreening form DD An additional collection of information using this form occurs when a Medical Evaluation Board is convened to determine the medical fitness of a fom member and if separation is warranted.

The primary collection of this information is from individuals seeking to join the Armed Forces. The DD Form is now ready for submission to the Department of Defense for review of your medical history. Find a military hospital or clinic Find a VA Facility. All your health records are shared with the VA.

Next provide your position, usual occupation, current medication, and allergies. Go through each medical issue and answer yes or no for each.

DD Form Report of Medical History – Military Forms – |

Although the Defense Health Agency may or may not use these sites as additional distribution channels for Department of Defense information, it does not exercise editorial control over all of the information that you may find at these locations. Do not leave any answers blank, you foem answer yes or no to each issue. 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.


You must fill in the corresponding bubble for each medical issue. You are leaving Health. A PDF reader is required for viewing. The DD Form is available on the Department of Defense documentation website or can be supplied through the chain of command. How do I schedule the exam? The form is used by military physicians to determine if an applicant can be accepted or should be disqualified on medical grounds. Completed forms are covered by recruiting, medical evaluation board, and official military personnel file SORNs maintained by each of the Services.

All 3 Policies 3 DD Form Questions 20 through 28 ask additional personal questions, which you must answer yes or no for each question. Before filling out the DD Formyou must first read the disclaimer and understand that you must forn truthfully to all questions or face criminal charges. This becomes part of your record. Put the examining location on box 5, giving the address of the location. You also may be interested in The appearance of hyperlinks 287-1 not constitute endorsement by the Defense Health Agency of non-U.

This may take a second or two. The examiner reviews your current health status and your complete medical history, including the DD Form The Separation Health Assessment documents and assesses your: A physician must attest 2087-1 your answers in boxes 10 through Boxes 10 through 19 ask you to indicate whether you have a history of specific medical conditions or illnesses. A DD Form is a Department of Defense form is used for gathering medical information for ad to military service.


Such links are provided consistent with the stated purpose of this website. First, fill out your basic information in boxes 1 through 4, providing xa name, social security number, and contact information. Find one near you: Showing results 1 – 4 Page 1 of 1.

Separation Health Assessment

How do I file a VA disability claim? The assessment results are then accessible by both the DoD and VA. Government sites or the information, products, or services contained therein. The examiner must sign and date the second page. Provide the information required in boxes 6 through 9, stating the military branch you are applying for, component, and purpose of the form.

You can also access them by using the Blue Button. 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.

Close Window Loading, Please Wait! This is to see if you need further treatment or evaluations for any medical concerns. DoD for, VA share results of the exam with each other. On the second page, provide your name and social security number at the top.

You can file a VA disability claim through eBenefitsin person with a Veterans Service Organization, or with a VA representative at a military installation.

You may be complete it at a military hospital or clinic or at a VA facility. You need only one exam. The DoD requires a separation history and physical examination to capture the complete medical history of Service Members and evaluate members filing a disability claim.