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INITIAL MEDICAL REVIEW ANNUAL MEDICAL CERTIFICATE. For use of this form, see AR 40-501; the proponent agency is OSG. DATA REQUIRED BY THE ...
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How to fill out da 7349 form
How to fill out DA 7349:
01
Start by filling out the date at the top of the form. Make sure to use the proper format (e.g., DD/MM/YYYY) for the date.
02
Next, fill in the requester's information in the "Requestor" section. Include the requester's full name, rank, unit, phone number, and email address.
03
In the "Patient" section, provide the patient's full name, social security number, and date of birth.
04
Indicate the purpose of the request in the "Purpose" section. Specify whether it is for medical evaluation, fitness for duty, separation, or other reasons.
05
If applicable, provide any supporting documentation or medical records related to the request in the "Supporting Documentation" section.
06
In the "Authorizations and Signatures" section, the requester must sign and date the form. If the requester is not the patient, the patient's signature is also required.
07
Finally, ensure that all required sections of the form are completed and reviewed for accuracy before submitting it.
Who needs DA 7349:
01
Service members: Active duty, reserve, and National Guard service members may need to fill out DA 7349 for various reasons, such as medical evaluations, fitness for duty screenings, or separations from the military.
02
Military healthcare providers: Medical professionals in the military may need to use DA 7349 to request medical evaluations or to document the results of medical assessments.
03
Commanders and unit leaders: These individuals may need to request medical evaluations or fitness for duty screenings for their service members, using DA 7349 as the official form for such requests.
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What is da 7349?
DA 7349 is a form used by the Department of Defense to report hazardous or unsafe working conditions.
Who is required to file da 7349?
All Department of Defense employees and contractors are required to file DA 7349 if they encounter any hazardous or unsafe working conditions.
How to fill out da 7349?
DA 7349 can be filled out electronically or in hard copy. Employees must provide details of the hazardous condition, location, and any steps taken to mitigate the risk.
What is the purpose of da 7349?
The purpose of DA 7349 is to ensure that hazardous conditions in the workplace are reported and addressed promptly to prevent accidents and injuries.
What information must be reported on da 7349?
Employees must report details of the hazardous condition, location, any immediate actions taken, and contact information.
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