The name of the medical and dental examiner must be legibly recorded, including rank and social security number. All reports of medical examination must be signed by a Medical Corps officer. If a physician’s assistant or a nurse practitioner did the initial examination, the report of medical examination must be countersigned by a Medical Corps officer.
REPORT OF MEDICAL HISTORY, SF 93
The SF 93, Report of Medical History, provides a record of complete medical history at the time of a member’s reporting for active duty. Subsequent reports of medical history are specifically required to record medical events that have occurred since the last SF 93 was completed. This is the minimum requirement; it is not incorrect to record a review of the member’s complete significant medical history, i.e., operations, hospitalizations, etc. Allow the member ample time and provide any necessary assistance to complete this form. Because illegible or incomprehensible abbreviations compromise the value of this report, spell out any abbreviation that may be misinterpreted.
The medical examiner is responsible for completing block 25, including signature, with legible name, rank, and social security number. All entries the medical examiner makes in block 25 must end with the abbreviations of “NCD” (not considered disqualifying) or “CD” (considered disqualifying).
OFFICER PHYSICAL EXAMINATION QUESTIONNAIRE, NAVMED 6120/2
The NAVMED 6120/2, Officer Physical Examination Questionnaire, provides the examinee the opportunity to review medical problems, life style, and other medical concerns to assist the medical examiner in adequately reviewing the officer’s health status. This form is an adjunct to the SF 93, Report of Medical History. Pending completion of a wellness evaluation form similar to the NAVMED 6120/2, the NAVMED 6120/2 should be used for all personnel, enlisted and officer alike, at the time of periodic medical examinations. Note: Date this report, recording the place of the medical examination and the printed name of the medical examiner.
SPECIAL DUTY MEDICAL ABSTRACT, NAVMED 6150/2
The NAVMED 6150/2, Special Duty Medical Abstract, represents a source of special information to the medical examiner regarding special physical qualifications the member requires to perform assigned duties. Bring information on the special duty medical abstract to the attention of the medical examiner at the time of each physical examination. Personnel assigned to aviation, submarine, or diving duties, as well as other specialized duties may require examination by a medical officer or Medical Service Corps officer specifically trained to perform the physical examination. ANNUAL CERTIFICATE OF PHYSICAL CONDITION, NAVMED 6120/3 The NAVMED 6120/3, Annual Certificate of Physical Condition, is principally an administrative form used by NROTC students, midshipmen, and others enrolled in officer training programs, and for inactive reservists. The member completes this form annually and submits it to his or her administrative office during the years between periodic physical examinations. A Medical Department representative (MDR) to the specific program manager reviews the certificate. When appropriate, the MDR orders the member to a more thorough physical examination if there is an indication of injury or illness that may impair the member’s ability to report to active duty.
TYPES OF PHYSICAL EXAMINATIONS
Each member of the armed services requires a physical examination at certain times in his or her career. The first of these is the enlistment, appointment, or commissioning physical examination, and the last is the separation physical examination. In addition to these two, there could be several more depending on the length of service or special requirements. All physical examinations must have the following tests or procedures performed: serologic test for syphilis and HIV (HTLV III) screen; urinalysis, to include protein, sugar, and microscopic examination; visual acuity; and dental examination.