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DA 3349 2004 free printable template

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DA FORM 3349 FEB 2004 DA FORM 3349 MAY 86 IS OBSOLETE. Page 1 of 2 APD PE v1. 03ES PATIENT S NAME CONTINUATION From page 1 Item 10. PHYSICAL PROFILE For use of this form see AR 40-501 the proponent agency is the Office of the Surgeon General* 1. MEDICAL CONDITION Description in lay terminology ILLNESS/DISEASE 2. CODES Table INJURY Or 7-2 AR 40-501 P U L H E S Temporary Permanent 4. PROFILE TYPE YES a* TEMPORARY PROFILE Expiration date YYYYMMDD NO Limited to 3 months duration b. PERMANENT...
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How to fill out DA 3349

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How to fill out DA 3349

01
Obtain a copy of the DA Form 3349 from your unit or the official Army website.
02
Fill in the soldier's personal information in the designated fields, including name, rank, and unit.
03
Specify the reason for the profile, clearly stating any medical conditions or limitations.
04
Indicate the length of the profile; this may be a temporary or permanent profile.
05
Ensure that the document is signed by a qualified healthcare provider.
06
Submit the completed DA 3349 to the appropriate personnel in your unit for processing.

Who needs DA 3349?

01
Soldiers who have medical conditions or physical limitations that require a temporary or permanent profile.
02
Unit commanders who need to document and manage soldiers' medical readiness and accommodations.

Who needs a DA 3349 Form?

The United States Department of the Army uses DA 3349 forms, filed separately for every soldier.

What is the DA 3349 Form for?

Regarded as a Physical Profile, DA Form 3349 is serves as a mode to register soldiers’ physical fitness level, capabilities, and abilities to perform certain activities, typical during the service. Therefore, it is proof that health of all the military members is strong enough for service.

Is the DA 3349 Form accompanied by other forms?

A DA 3349 form can be used as both a permanent and temporary physical profile. A temporary physical profile is required in case of the event (injury or illness) causing certain physical limitations. As a temporary profile, DA Form 3349 is filed along with a DA Form 689 — Individual Sick Slip.

If the DA 3349 form cannot provide enough space for all the information on the limitations for physical activities as SF 600 form should be used as a continuation of the DA 3349.

When is DA 3349 Form due?

If used as a temporary physical profile, DA 3349 cannot exceed 30 days. When used to register permanent physical condition, it applies for the next 12 months.

How do I fill out DA 3349 Form ?

The primary point to specify on the form, is whether it is permanent or temporary.

The completed Form must provide the information as for:

the soldier’s medical condition

ability/inability to perform functional activities

description of physical limitations (if any)

the soldier’s name and grade

name and grade of approving authority

soldier’s patient identification

Where do I send DA 3349 Form?

The submitted DA 3349 forms are kept by the NCO’s so that they can elaborate appropriate activities and to be performed by their teams.

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A profile means you have a injury or medical condition that keeps you from performing in some or all your duties. Say you have a sprained ankle. Your profile might state, no running, marching or standing for extended periods of time x 14 days.
PURPOSE: The Summary of Care by Non-Military Medical Provider form provides the Army Healthcare team with essential current and relevant medical information for Soldiers seen by civilian network partners, to ensure that any functional limitation(s) is/are documented in a physical profile (DA Form 3349) when warranted.
If a profile is needed the Soldier must complete a profile request packet and send packet to usarmy.usarc.usarc-hq.mbx.armmc@mail.mil (AR-MMC mailbox). It is also the Soldiers responsibility to report medical conditions that effect medical readiness to their commander.
A DA Form 3349 will be used by the United States Department of the Army. It is known as a Physical Profile form and it will be used as a way to keep a record of a soldier's physical profile.
After you have logged in, click on the icon that identifies your service record. You will see your information. On the left side of the web page, under the heading "Navigation," you can click on the word "Documents" to view the documents in your record. To print, click on the document of your choosing.

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DA 3349 is a form used by the United States Army to document and report a soldier's physical and mental health status, typically during the evaluation process for administrative actions.
DA 3349 must be filed by military healthcare providers, typically in situations where a soldier's fitness for duty is being assessed or if they are undergoing a medical evaluation board.
To fill out DA 3349, one must provide accurate and detailed information about the soldier's medical condition, include relevant medical history, and ensure all sections are completed as per the instructions provided in the form.
The purpose of DA 3349 is to formally document a soldier's medical status and to assist in determining their eligibility for military service, including fitness for deployment, assignments, or medical boards.
Information that must be reported on DA 3349 includes the soldier's name, rank, unit, date of evaluation, specific medical conditions, treatment recommendations, and comments regarding the soldier's fitness for duty.
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