Printable blank Report of Medical History

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What is the Report of Medical History?

Report of Medical History is a document that is used by the Department of Defence. The form helps the organization to get more information about the medical condition of a person that wishes to join the US Armed Forces.

What I need a Report of Medical History for?

You will have to fill out Report of Medical History in order to:

  • Provide the Department of Defence (DoD) with the required information about your medical state.

You must fill out the form if you wish to join the US Armed Forces. If the information was given incorrectly, the process of considering the application will be delayed.

How to fill out a Report of Medical History?

Note that if you answer untruthfully you will have to face criminal charges.
Start writing your full name, address, telephone number and date of filling the form. Do not forget to mention your social security number. The postal code is required. Write the purpose of your examination and branches you want to apply for.

Report of Medical History requires you to mention all the allergies you have. Provide the full information about your medical history. The names of doctors and hospitals are required. After the examination, you might add some additional information. Your signature is required.

Organizations that work with Report of Medical History

Department of Defence.

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