Medical History Report for Armed Forces Applicants
This Medical History Report is designed to gather essential health information from applicants seeking enlistment in the Armed Forces. It evaluates medical fitness for various military roles and ensures all health conditions are accounted for. By providing accurate details, applicants can facilitate a smoother enlistment process.
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How do I fill this out?
Begin by carefully reading each question to ensure you understand what is being asked. Fill in your personal information at the top of the form, including your name and social security number. Answer all medical questions honestly and to the best of your ability, marking 'Yes' or 'No' as applicable.

How to fill out the Medical History Report for Armed Forces Applicants?
1
Read the entire form before starting.
2
Fill in your personal details accurately.
3
Answer all health-related questions truthfully.
4
Ensure all applicable boxes are checked.
5
Review your completed form for any errors.
Who needs the Medical History Report for Armed Forces Applicants?
1
Individuals applying for enlistment in the Armed Forces.
2
Service members undergoing evaluation for deployment.
3
Candidates for military academies requiring medical clearance.
4
Those involved in National Guard or Reserve service assessments.
5
Applicants for ROTC scholarship programs needing medical review.
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What are the instructions for submitting this form?
To submit the completed Medical History Report, send it to your military recruiting office via designated submission methods such as email or fax. Ensure that you include all necessary documentation alongside the form. Check your local recruitment office's website for specific submission details and contact information for inquiries.
What are the important dates for this form in 2024 and 2025?
No significant changes to the Medical History Report are anticipated in 2024 and 2025. Please check for the latest updates on submission procedures and deadlines at the beginning of those years. Always stay informed of any regulations affecting military enlistment.

What is the purpose of this form?
The primary purpose of this form is to gather comprehensive medical history information from applicants for military service. It plays a crucial role in determining the medical fitness of individuals applying for enlistment, ensuring that all potential health issues are disclosed. Accurate information on this form aids the military in assessing an applicant's suitability for service and maintaining the overall health and readiness of the Armed Forces.

Tell me about this form and its components and fields line-by-line.

- 1. Last Name, First Name, Middle Name (Suffix): Fields to enter the applicant's full legal name.
- 2. Social Security Number: A field for the applicant's social security number.
- 3. Home Address: The applicant's residential address including street, city, state, and ZIP code.
- 4. Home Telephone: The contact number for the applicant.
- 5. Service, Component: Indicates the military branch and component the applicant is applying for.
- 6. Position and Purpose of Examination: Field to describe the examination role and purpose.
- 7. Current Medications: List of any medications the applicant is currently taking.
- 8. Allergies: Record any known allergies.
- 9. Medical History Questions: A series of questions addressing the applicant's past and present health issues.
- 10. Examiner's Summary: A field for the medical examiner to summarize and elaborate on the findings.
What happens if I fail to submit this form?
Failure to submit the Medical History Report may result in delays in the enlistment process. Applicants may miss important deadlines and have their applications rejected due to incomplete information.
- Delayed Processing: Without timely submission, the review of your application may be postponed.
- Possible Rejection: Inadequate or missing medical information could lead to rejection of your enlistment.
- Non-Deployable Status: For existing service members, not filling this form may result in being placed in a non-deployable category.
How do I know when to use this form?

- 1. Enlistment Application: Used when submitting an application for enlistment in the military.
- 2. Medical Evaluations: Required for medical evaluations conducted for service members.
- 3. Annual Health Reviews: Needed for annual health assessments of active service members.
Frequently Asked Questions
How do I fill out the Medical History Report?
Carefully read through each section and provide accurate information to ensure your application is processed smoothly.
Can I edit this PDF once filled out?
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After making your changes, use the download feature to save the edited PDF to your device.
What if I make a mistake on the form?
You can easily correct any mistakes by editing the fields as needed on PrintFriendly.
Is this form necessary for all applicants?
Yes, all applicants seeking enlistment must complete this Medical History Report.
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What should I do if I have health concerns?
It's important to be honest in your disclosures; seek guidance if you're not sure about answers.
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