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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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.

The examiner must sign and date the second page. The Separation Health Assessment documents and assesses your: The assessment results are then accessible by both the DoD and VA.

You also may be interested in Provide the information required in boxes 6 through 9, stating the military branch you are applying for, component, and purpose of the form. You need only one exam. The physician may provide additional comments in box 30, adding additional information that they feel is important. 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.

This may take a second or two. How do I file a VA disability claim?

You may be complete it at a military hospital or clinic or at a VA facility. Boxes 10 through 19 ask you to indicate whether you have a history of specific medical conditions or illnesses.

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 vorm date.


The form is used by military physicians to determine if an applicant can be accepted or should be disqualified on medical grounds. At your exam, the examiner reviews your answers and ensures claimed contentions are addressed in the exam report. All your health records are shared with the VA. Fomr can also access them by using the Blue Button. 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.

DD Form Report of Medical History – Military Forms – |

All 3 Policies 3 DD Form You can schedule 22807-1 exam at any military hospital or clinic or VA facility. The appearance of hyperlinks does not constitute endorsement by the Defense 2870-1 Agency of non-U. Showing results 1 – 4 Page 1 of 1. You must fill in the corresponding bubble for each medical issue. Such links are provided consistent with the stated purpose of this website. Do not leave any answers blank, you must answer yes or no to each issue.

First, fill out your basic information in boxes 1 through 4, providing your name, social security number, and contact information. This becomes part of your record. The examiner reviews your current health status and your dx medical history, including the DD Form Put the examining location on box 5, giving the address of the location.

Close Window Loading, Please Wait! A DD Form is a Department of Defense form is used for 2807–1 medical information for applicants to military service.

Go through each medical issue and answer yes or no for each. Completed forms are covered by recruiting, medical evaluation board, and official military personnel file SORNs maintained by each of the Services. The DD Form is now ready for submission to the Department of Defense for xa of your medical history. This is to see if you need further dq or evaluations for any medical concerns.

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How do I schedule the exam? Find a military hospital or clinic Find a VA Facility. You can file a VA disability claim through eBenefitsin person with a Veterans Service Organization, or with a VA representative at a military installation.

The information collected on this form is used to assist DoD physicians fogm making determinations as to acceptability of applicants for military service and verifies disqualifying medical condition s noted on the prescreening form DD The primary collection of this information is from individuals seeking to join the Armed Forces.

DoD and VA share results of the exam with each other.

Separation Health Assessment

Next provide your position, usual occupation, current medication, and allergies. You are leaving Health. Find one near you: 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. A physician must attest to your answers in boxes ds through gorm 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.

Government sites or the information, products, or services contained therein.

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