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INTERNATIONAL CERTIFICATES OF VACCINATION (PHS-731)

All personnel performing international travel should be immunized in accordance with NAVMEDCOMINST 6230.15, Immunizations and Chemoprophylaxis, and the current edition of FM 8-33/NAVMED P-5038, Control of Communicable Diseases of Man. Service members should have a properly completed and authenticated PHS-731 form (International Certificates of Vaccination) in their possession. The PHS-731 form is issued to service members for independent international travel. This form, kept by the individual, is a personal record of immunizations. The PHS-731 is not to be filed in the HREC at any time. Any immunizations recorded on the PHS-731 should be transcribed onto the SF 601.

According to international rules, entries on the PHS-731 require authentication for immunizations against smallpox (if administered), yellow fever, cholera, and anthrax. Authentication (proof the immunization has been given) is accomplished by stamping each entry with the Department of Defense (DoD) immunization stamp and by the healthcare provider's signature. The signature block may be stamped or typewritten and authenticated with the healthcare provider's signature.

ABSTRACT OF SERVICE AND MEDICAL HISTORY (NAVMED 6150/4)

This form provides a chronological history of the ships and stations to which a member has been assigned for duty and treatment, and an abstract of medical history for each admission to the Sick List.

A NAVMED 6150/4 (fig. 12-7) is prepared upon opening the health record, and it remains with the health record regardless of any change in the member's status. Continuation sheets are incorporated whenever a current abstract is completely filled. Complete columns of the NAVMED 6150/4 as follows:

Ship or Station column. Enter the name of the ship or command to which the member is

attached for duty or treatment.
Diagnosis, Diagnosis Number, and Remarks column. Enter the diagnosis title and International Classification of Diseases (ICDA) number each time final disposition from the Sick List is made. When there is more than one diagnosis for a single admission, record each diagnosis.

Date column. Indicate in the "From" and "To" subcolumns all dates of reporting and detachment for duty or dates of admission and discharge from the Sick List. Upon transfer for temporary duty (TDY), make an entry only if the HREC accompanies the individual to the place of TDY.

NAVMED 6150/4 is retained as a permanent part of the HREC. Whenthe record is closed, make an entry indicating the date, title of servicing activity, and explanatory circumstances.

Upon discharge and immediate reenlistment, or change in status, an appropriate entry to this effect should be made on the current NAVMED 6150/4. Subsequent chronological entries are continued on the same form.

RECORD OF OCCUPATIONAL EXPOSURE TO IONIZING RADIATION (DD FORM 1141)

This form is initiated when military personnel are first exposed to ionizing radiation (with the exception of patients incurring such radiation while undergoing diagnostic treatment). This form becomes a permanent part of the member's health record. Instructions for preparing DD Form 1141 are on the back of the form. Further instruction concerning the applicability and use of the form are contained in the Radiation Health Protection Manual, NAVMED P-5055.

Figure 12-7.-Abstract of Service and Medical History, NAVMED 6150/4.







Western Governors University
 


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