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Back REPORT OF MEDICAL EXAMINATION | Up Hospital Corpsman 3 & 2 - Intro Navy Nursing manual for hospital training purposes | Next ROUTINE/PERIODIC EXAMINATIONS |
The name of the medical and dental examiner
must be legibly recorded, including rank and
social security number. All reports of medical
examination must be signed by a Medical Corps
officer. If a physicians assistant or a nurse prac-
titioner did the initial examination, the report of
medical examination must be countersigned by a
Medical Corps officer.
REPORT OF MEDICAL HISTORY,
SF 93
The SF 93, Report of Medical History, pro-
vides a record of complete medical history at the
time of a members reporting for active duty.
Subsequent reports of medical history are specif-
ically required to record medical events that have
occurred since the last SF 93 was completed. This
is the minimum requirement; it is not incorrect
to record a review of the members complete
significant medical history, i.e., operations,
hospitalizations, etc. Allow the member ample
time and provide any necessary assistance to com-
plete this form. Because illegible or incomprehen-
sible abbreviations compromise the value of this
report, spell out any abbreviation that may be
misinterpreted.
The medical examiner is responsible for com-
pleting block 25, including signature, with legible
name, rank, and social security number. All en-
tries the medical examiner makes in block 25 must
end with the abbreviations of NCD (not con-
sidered disqualifying) or CD (considered
disqualifying).
OFFICER PHYSICAL EXAMINATION
QUESTIONNAIRE, NAVMED 6120/2
The NAVMED 6120/2, Officer Physical Ex-
amination Questionnaire, provides the examinee
the opportunity to review medical problems, life
style, and other medical concerns to assist the
medical examiner in adequately reviewing the of-
ficers health status. This form is an adjunct to
the SF 93, Report of Medical History. Pending
completion of a wellness evaluation form similar
to the NAVMED 6120/2, the NAVMED 6120/2
should be used for all personnel, enlisted and of-
ficer alike, at the time of periodic medical ex-
aminations. Note: Date this report, recording the
place of the medical examination and the printed
name of the medical examiner.
9-3
SPECIAL DUTY MEDICAL
ABSTRACT, NAVMED 6150/2
The NAVMED 6150/2, Special Duty Medical
Abstract, represents a source of special informa-
tion to the medical examiner regarding special
physical qualifications the member requires to per-
form assigned duties. Bring information on the
special duty medical abstract to the attention of
the medical examiner at the time of each physical
examination. Personnel assigned to aviation, sub-
marine, or diving duties, as well as other special-
ized duties may require examination by a medical
officer or Medical Service Corps officer specif-
ically trained to perform the physical examination.
ANNUAL CERTIFICATE OF
PHYSICAL CONDITION,
NAVMED 6120/3
The NAVMED 6120/3, Annual Certificate of
Physical Condition, is principally an adminis-
trative form used by NROTC students, mid-
shipmen, and others enrolled in officer training
programs, and for inactive reservists. The member
completes this form annually and submits it to
his or her administrative office during the years
between periodic physical examinations. A
Medical Department representative (MDR) to the
specific program manager reviews the certificate.
When appropriate, the MDR orders the member
to a more thorough physical examination if there
is an indication of injury or illness that may im-
pair the members ability to report to active duty.
TYPES OF PHYSICAL
EXAMINATIONS
Each member of the armed services requires
a physical examination at certain times in his or
her career. The first of these is the enlistment,
appointment, or commissioning physical examina-
tion, and the last is the separation physical ex-
amination. In addition to these two, there could
be several more depending on the length of service
or special requirements. All physical examinations
must have the following tests or procedures per-
formed: serologic test for syphilis and HIV
(HTLV III) screen; urinalysis, to include protein,
sugar, and microscopic examination; visual acu-
ity; and dental examination.
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