NAVMED 6110/4 2011-2026 free printable template

PHYSICAL FITNESS ASSESSMENT MEDICAL CLEARANCE/WAIVER SECTION 1 Completed by member A. Command C. CFL/POC B. Member CO/OIC Signature PATIENT S NAME Last First Middle Initial SEX SSN / IDENTIFICATION NO. RANK/GRADE RECORDS MAINTAINED AT NAVMED 6110/4 01/2011 STATUS DATE OF BIRTH. UIC/RUIC D. CFL Telephone No* E* Reason for Referral Positive PARFQ Screening Yes No Expired PHA Age 50 years Injury/Illness No PRT in last year Completed by AMDR/Treating Provider A. PRT Waiver Curl-Ups Push-Ups...

How to fill out navmed 6110 4 2025 form

How to fill out NAVMED 6110/4

1. Begin by downloading the NAVMED 6110/4 form from the appropriate military website.
2. Fill in the personal identification information at the top of the form, including name, rank, and service number.
3. Complete the 'Physical Readiness Program' section by providing details of your physical readiness training.
4. In the 'Exercise Program' section, describe your planned exercises, frequency, duration, and intensity.
5. Ensure all medical history information is filled out accurately, including any physical limitations or medical conditions.
6. Review the 'Assessment' section and provide any necessary evaluations of your current physical condition.
7. Have the form reviewed and signed by an authorized supervisor or medical professional.
8. Submit the completed form to the appropriate command or medical review authority.

Who needs NAVMED 6110/4?

1. NAVMED 6110/4 is needed by all military personnel who are participating in physical readiness programs.
2. It is required for those undergoing physical assessments or evaluations.
3. Commanding officers and medical personnel may also need it for record-keeping and monitoring purposes.

People Also Ask about 30475638

What happens if you miss Navy PRT?

The PRT, to include Bad Day retest, must be completed with 45 days from the official BCA. If the recorded PRT is not completed within 45 days of the official BCA, the CO may assign a participation status of "UA" for the PRT.

How do I become exempt from Navy PRT?

Sailors who pass the body composition assessment (BCA), are within the Navy age-graduated body fat standards, and score an overall excellent low or better (with no single event lower than good low) on the physical readiness test (PRT) will be exempt from participation in the following PRT cycle.

Is PT mandatory in the Navy?

The U.S. Navy's physical training requirements are not a "one-and-done" program, where once you're in the Navy you can ignore PT. The PT program requirements keep sailors fit throughout their service career. You're tested regularly. The requirements vary based your age, sex and mission.

How long is a Parfq good for?

As per policy, the PHA is only valid for one-year (365 days). If a CFL has the signed PHA completion form from medical, the CFL can manually enter the PHA completion date in the “Edit Member Record” tab in PRIMS to allow the member to complete the PARFQ.

How do I skip a Navy PRT?

If you pass the body composition assessment and score an overall excellent low or better on the physical readiness test, you may have the opportunity to be validated on the subsequent Physical Fitness Assessment cycle and skip the PRT, if you pass the BCA and are within the age-adjusted standards.

How do I get a BCA waiver in the Navy?

a. BCA medical waiver must be issued on a NAVMED 6110/4 and will require two signatures: (1) The physician (military or civilian) recommending the waiver; and (2) AMDR physician. A military physician must endorse the waiver.

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What is NAVMED 6110/4?

NAVMED 6110/4 is the form used by the United States Navy to report medical evaluations for physical readiness, specifically focusing on Body Composition Assessment.

Who is required to file NAVMED 6110/4?

All active duty and reserve service members in the Navy are required to file NAVMED 6110/4 as part of their physical fitness assessments.

How to fill out NAVMED 6110/4?

NAVMED 6110/4 must be filled out by providing personal information, including name, rank, and date of birth, along with measurements for height, weight, and waist circumference. It should also include the results of physical fitness tests as applicable.

What is the purpose of NAVMED 6110/4?

The purpose of NAVMED 6110/4 is to maintain a standard of physical readiness among Navy personnel by monitoring body composition and ensuring compliance with Navy fitness standards.

What information must be reported on NAVMED 6110/4?

NAVMED 6110/4 requires reporting of the service member's personal details, height, weight, waist measurements, body fat percentage, and results from physical fitness assessments.