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Clinical & provider-completed forms

Provider Forms

Forms completed by a clinician or examiner — physical examinations, the longitudinal preventive-care record, dental readiness, duty-limitation profiles, and special-duty recommendations.

Library

7 forms

Provider-completed

Exams & health record

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DD 2808 — Report of Medical Examination

Provider-completed physical examination

ProviderOpen →

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DD Form 2766 — Adult Preventive and Chronic Care Flowsheet

Longitudinal preventive-care record

On fileOpen →

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DD Form 2766C — Adult Preventive and Chronic Care Flowsheet (Continuation)

Continuation sheet

On fileOpen →

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SF 600 — Chronological Record of Medical Care

Provider encounter note

ProviderOpen →

Dental

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DD 2813 — Dental Examination

Dental readiness examination · completed by a dental officer

ProviderOpen →

Profiles & duty limitations

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DA Form 3349 — Physical Profile (e-Profile)

Provider-completed when a condition limits duty

ProviderOpen →

Special duty

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DD 2992 — Medical Recommendation for Flying or Special Operational Duty

Aviation / special-duty medical recommendation

Special dutyOpen →